Chapter Twenty-Six: Patient Accounts

Question 1

account

Answer 1

record of all transactions made on an individual’s financial record that lists debits, credits, and balance

Question 2

accounts payable (A/P)

Answer 2

the total amount owed by the practice to suppliers and other service providers for regular business operating expenses, such as medical office supplies and equipment, office rental space, utilities (gas and electric, water, telephone and/or Internet services), and office staff salaries.

Question 3

accounts receivable (A/R)

Answer 3

all the outstanding accounts (amounts due to the office); a reporting system to see who has not paid on their account

Question 4

adjudication

Answer 4

the insurance company process of reviewing medical claims for necessary information before making the payment

Question 5

adjustments

Answer 5

credit entry made on an account to decrease a balance owed to the medical office; may be due to insurance, professional discounts, write-offs, or to correct bookkeeping errors

Question 6

balance

Answer 6

the difference between debit and credit

Question 7

bookkeeper

Answer 7

one who records the accounts and transactions of a business

Question 8

charges

Answer 8

fee for services rendered

Question 9

credit

Answer 9

a payment subtracted from existing balance

Question 10

credit balance

Answer 10

occurs when the amount paid is greater than was due or the account is being paid in advance of service provided

Question 11

day sheet

Answer 11

form used for recording all daily financial transactions of charges made and payments received; also called a daily journal. All patient charges and receipts are recorded on the day sheet each day (primarily with manual bookkeeping systems).

Question 12

debit

Answer 12

to deduct, to charge; a charge added to existing balance

Question 13

debit balance

Answer 13

occurs when the amount paid is less than the total due

Question 14

journalizing

Answer 14

entries on the daily log; when an entry is made on the manual day sheet

Question 15

ledger

Answer 15

a record of all charges or services rendered, any payments made by the patient or the insurance carrier, and any adjustments, including with the specific dates of these entries

Question 16

medical record numbers [MRNs]

Answer 16

patient account number; an identifier for the patient/beneficiary chosen by the provider and may consist of numbers, letters, or a combination of both

Question 17

payments

Answer 17

money paid by the patient or the insurance carrier

Question 18

posting

Answer 18

the transfer of information from one record to another. This might be an automated process, depending on the electronic system in place

Question 19

remittance advice

Answer 19

document sent (electronic or paper) from the insurance company to the practice with the approved amount and payment for services provided to the patient similar to the explanation of benefits (EOB) the patient receives from the insurance company

Question 20

revenue cycle

Answer 20

all aspects and transactions and include (but not limited to) procedure/service coding/charge capture, claim submission, billing, collections, payments, and more. Every aspect of the revenue cycle impacts billing and accounting.

Question 21

Revenue Cycle Management

Answer 21

managing the financial side of the medical business; more explicitly, RCM is “the administration of financial transactions that result from the medical encounters between a patient and a provider, facility, and/or supplier (HBMA).”

Question 22

visit capture (sometimes called charge entry)

Answer 22

sometimes called charge entry; entering of the diagnosis codes and procedures codes for the patient encounter and information such as date of service (DOS), units of service, CPT modifiers, authorizations number, provider details, billed amount, etc.