Collecting AR Flashcards
What is the primary responsibility of the billing office?
Collecting on balances.
Aug. 2021, 7.3
Define collection ratios.
A ratio of payments to charges.
Aug. 2021, 7.4
What are the two kinds of collection ratios?
- Gross
- Net
(Aug. 2021, 7.4)
What is the gross collection ratio formula?
The sum of all payments (minus refunds)
÷
Total charges
(Aug. 2021, 7.4)
What is the net collection ratio formula?
Sum of all payments (minus refunds)
÷
Total charges (minus contractual write-offs and self-pay discounts).
(Aug. 2021, 7.4)
What does professional billing use to calculate collection ratios?
Sums of transactions
Aug. 2021, 7.4
True or False:
The Epic-released PB Collection Ratio Summary Dashboard displays collection ratios grouped by payer and other summary levels.
True
Aug. 2021, 7.4
How are HB collection ratios defined?
HB Collection Ratios =
Total amount of payments
÷
Total amount of charges on the HAR.
(Aug. 2021, 7.4)
What happens when a write-off is performed?
The remaining balance of a charge or a bucket is lowered due to an adjustment.
(Aug. 2021, 7.5)
WHERE is the primary write-off reason listed in PB?
On each charge.
Aug. 2021, 7.5
WHERE is the primary write-off reason listed in HB?
On the hospital account.
Aug. 2021, 7.5
List the write-offs expected by an organization:
- 1 - Contractual
- 2 - Self-pay discount/charity
- 3 - Other allowance
(Aug. 2021, 7.5)
What category values indicate that your organization is not receiving money that was anticipated?
All of them except 1, 2, or 3.
Aug. 2021, 7.6
Define expected allowed amount.
The amount your organization has calculated from the contract.
aka the expected amount or Epic allowed amount
(Aug. 2021, 7.7)
Define allowed amount.
The amount the payer has calculated for reimbursement.
aka the payer allowed amount
(Aug. 2021, 7.7)
What is the difference between the total billed amount and the allowed amount?
The not allowed amount.
Aug. 2021, 7.7
Define paid amount.
What the payer has sent for reimbursement.
This is usually the same as or close to the allowed amount.
(Aug. 2021, 7.7)
What is the difference between what your organization expected to receive and what you actually receive called?
The variance.
Aug. 2021, 7.7
Variance = ? - ?
Variance = expected allowed amount - allowed amount
Aug. 2021, 7.8
Why is it common to use absolute values when summing total variance?
So that there is no need to offset under and overpayments when grouping results.
(Aug. 2021, 7.8)
Allowed amount = ? - ?
Allowed amount = total billed - not allowed
Aug. 2021, 7.8
What is an organization’s most accurate estimate of what payments they actually expect to receive?
AR valuation
Aug. 2021, 7.10
