HA207_M3_Worksheet (1)

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Jan 9, 2024

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1401 Dove St, Newport Beach, CA 92660 HA207 Module 3 Worksheet Directions: Respond to each of the prompts below. Your responses should be substantive (2 to 5 sentences for each). 1. Ann Reynolds has recently been hired as practice manager for Dr. LaRue. In reviewing the financial records of the practice, she notices that a substantial amount of money is owed by patients with outstanding balances. Further review finds that the practice has no written financial policies outlining the responsibility of patients in paying for their costs of medical care. Outline a set of basic financial policies to address patient responsibility for payment of charges. A set of basic financial policies to address patient responsibility for payment of charges would start by establishing the use of collection agencies and considering dismissal of those that are 6 months or more behind. Than I would ensure that prior to every visit that either a payment plan is established, or payment is due at time of service and using discounts for self-pay patients. 2. Tom Gregory is the practice manager for a local urologist. The practice has a detailed set of financial policies dealing with required payments from patients, but the staff have not been enforcing the policies and patients are not familiar with the requirements or the reasoning behind these policies. How does Mr. Gregory address this issue?

1401 Dove St, Newport Beach, CA 92660 I would think Mr. Gregory would address this issue by creating a form that clearly explains the policies and why they are in place, then requiring the employees to have the form filled out during the check in process as well as training the staff to be firm but professional regarding collecting of payments at time of service. 3. Granite State Medical is experiencing claims denials in a larger percentage than industry average. As the practice administrator, what steps would you take to bring down the percentage of denials? As the practice administrator, I would first make sure that I am checking the process in which the claims are being performed to ensure that they are being done accurately and with the correct codes and CPT codes. Checking for errors throughout the process can definitely improve the amount of claim denials. 4. As practice manager for a single-physician medical office, you notice that the physician is coding most patient contacts as simple office visits, and the practice is reimbursed by insurance at the lower reimbursement level. How do you ensure that the practice is paid for all appropriate costs of medical services provided? I would first speak with the physician in the office which likely already is aware of this due to it being a small office, then ensure that he understands that coding most patients at lower complexity visits is reimbursing at a lower level due to the choice of codes. Than work with said provider and

1401 Dove St, Newport Beach, CA 92660 see in what ways he/she can improve on high complexity visits which will bring a higher reimbursement rate. 5. John Donald is an established patient at a medical practice. He has chronic health conditions. Mr. Donald also has a history of missing appointments without any providing prior notification to the practice. As the practice manager for the office, what steps would you take to convince Mr. Donald to stop missing appointments? As the practice manager for the office, I would ensure that a policy regarding no show or advance cancellation notice of at least 24 hours is required. If notice isn’t given and the patient isn’t shown to the appointment, I would create a fee for the patient to pay. This would get the patient to understand the value of the offices time and be an incentive to come to scheduled appointments. 6. Drs. Findley and Rocker are partners in a family medicine practice. The practice appears to be busy and well run, but always seems to be short on cash at the end of the month. Billing rates are appropriate, and staff member salaries and draws of the partners are in line with the area. You are the practice administrator, and the partners have asked that you review the problem and make recommendations. What areas will you look at to improve the revenues of the practice? I would check the office and see if any departments within the practice are operating efficiently and see where costs may be cut by improving time and patient flow, than I would likely check the insurance reimbursement

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1401 Dove St, Newport Beach, CA 92660 contracts and see how and if they can be improved to allow for more revenue to come in per patient. Questions are from instructor companion resources for textbook: Harrison, C., Harrison, W., & Taylor, C. (2024). Introduction to Health Care Finance and Accounting . Cengage Unlimited.

HA207_M3_Worksheet (1)

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