Professional Fees, Billing & Coding Hi-1011- Chapter 19

1. TOS payments should be encouraged

True

False

Encouraging TOS (Terms of Service) payments is beneficial because it ensures that users comply with the terms and conditions set by a company or platform. By making these payments, users acknowledge and agree to abide by the rules, which helps maintain a fair and secure environment for all users. TOS payments also provide a source of revenue for the company, enabling them to continue offering their services and improving the platform for users.

Explanation

Encouraging TOS (Terms of Service) payments is beneficial because it ensures that users comply with the terms and conditions set by a company or platform. By making these payments, users acknowledge and agree to abide by the rules, which helps maintain a fair and secure environment for all users. TOS payments also provide a source of revenue for the company, enabling them to continue offering their services and improving the platform for users.

2. True and Lending Act needs to be followed with patients that credit has been extended to and the office is applying finance charges to the account

True

False

The True answer is correct because the Truth in Lending Act requires that lenders provide clear and accurate information about the terms and costs of credit to borrowers. This includes disclosing any finance charges that will be applied to the account. By following this act, lenders ensure transparency and protect the rights of borrowers.

Explanation

The True answer is correct because the Truth in Lending Act requires that lenders provide clear and accurate information about the terms and costs of credit to borrowers. This includes disclosing any finance charges that will be applied to the account. By following this act, lenders ensure transparency and protect the rights of borrowers.

3. You should not continue to see patients that have filed bankruptcy

True

False

Continuing to see patients who have filed bankruptcy is not prohibited or unethical. Bankruptcy is a legal process that allows individuals or businesses to reorganize or eliminate their debts. It does not affect a patient's ability to receive medical care or the healthcare provider's ability to treat them. Therefore, it is not necessary to stop seeing patients who have filed bankruptcy.

Explanation

Continuing to see patients who have filed bankruptcy is not prohibited or unethical. Bankruptcy is a legal process that allows individuals or businesses to reorganize or eliminate their debts. It does not affect a patient's ability to receive medical care or the healthcare provider's ability to treat them. Therefore, it is not necessary to stop seeing patients who have filed bankruptcy.

4. You can bill a minor if you don't have the parent's information

True

False

The statement is false because in most cases, you cannot bill a minor without the parent's information. Minors are typically not legally responsible for their own medical bills, and healthcare providers require the parent's information to ensure proper billing and payment. Without the parent's information, it would be difficult to collect payment or communicate with the responsible party for the minor's healthcare expenses.

Explanation

The statement is false because in most cases, you cannot bill a minor without the parent's information. Minors are typically not legally responsible for their own medical bills, and healthcare providers require the parent's information to ensure proper billing and payment. Without the parent's information, it would be difficult to collect payment or communicate with the responsible party for the minor's healthcare expenses.

5. Face to face collection efforts are not very effective

True

False

The statement suggests that face to face collection efforts are not effective, but the correct answer is False. This means that face to face collection efforts are actually effective.

Explanation

The statement suggests that face to face collection efforts are not effective, but the correct answer is False. This means that face to face collection efforts are actually effective.

6. Insurance companies should have claims sent to them daily

True

False

True. Insurance companies should send claims daily to the insurance company to continue the financial flow within the office for services rendered.

Explanation

True. Insurance companies should send claims daily to the insurance company to continue the financial flow within the office for services rendered.

7. Only one collection letter should be sent to a patient prior to sending them to a collection agency service

True

False

Multiple collection letters should be sent to a patient prior to sending them to a collection agency service. This is because sending multiple letters gives the patient ample opportunity to settle their outstanding debts before resorting to involving a collection agency. It also ensures that the patient is aware of their financial obligations and provides them with a fair chance to address the issue before further actions are taken.

Explanation

Multiple collection letters should be sent to a patient prior to sending them to a collection agency service. This is because sending multiple letters gives the patient ample opportunity to settle their outstanding debts before resorting to involving a collection agency. It also ensures that the patient is aware of their financial obligations and provides them with a fair chance to address the issue before further actions are taken.

8. The full amount paid by the insurance company for a procedure is referred to as

Set amount

Adjusted amount

Allowable amount

Determined amount

The term "allowable amount" refers to the total sum that an insurance company is willing to pay for a specific medical procedure. This amount is predetermined and agreed upon between the insurance company and the healthcare provider. It represents the maximum reimbursement that the insurance company will cover, and any additional costs beyond this amount would typically be the responsibility of the patient.

Explanation

The term "allowable amount" refers to the total sum that an insurance company is willing to pay for a specific medical procedure. This amount is predetermined and agreed upon between the insurance company and the healthcare provider. It represents the maximum reimbursement that the insurance company will cover, and any additional costs beyond this amount would typically be the responsibility of the patient.

9. You can collect the payment for a patient that has had their account turned over to a collection agency

True

False

True. Any payment received needs to be turned over to the collection agency.

Explanation

True. Any payment received needs to be turned over to the collection agency.

10. The insurance contract exists between the insurance company and the

Doctor

Guarantor

Insured

Minor

The insurance contract exists between the insurance company and the insured. The insured refers to the person or entity that is covered by the insurance policy. They are the ones who purchase the insurance and are protected against potential financial losses or damages. The insurance company, on the other hand, is the provider of the insurance coverage and agrees to compensate the insured in case of covered events or risks. The insured pays premiums to the insurance company in exchange for this coverage.

Explanation

The insurance contract exists between the insurance company and the insured. The insured refers to the person or entity that is covered by the insurance policy. They are the ones who purchase the insurance and are protected against potential financial losses or damages. The insurance company, on the other hand, is the provider of the insurance coverage and agrees to compensate the insured in case of covered events or risks. The insured pays premiums to the insurance company in exchange for this coverage.