Billing and Collections Chiropractic Assistant

File: Office Binder \ Billing & Collections

BILLING AND COLLECTIONS DEPARTMENT

DUTIES AND RESPONSIBILITIES

Note: This is a list of the duties of the department. Some of these may be performed by the front desk assistants or other staff. Each of these duties should be explained in a procedural manual. This is list can act as a table of contents for the manual.

MISSION OF THE BILLING & COLLECTIONS: Ensure that all services rendered are accounted and billed for, and collected, in a timely and efficient manner.

OUTCOME:

· All services inputted, accounted for, and billed within 15 days of receipt.

· All patient accounts collected as soon as reasonable.

PERFORMANCE MONITORS:

· Total collections

· Percent of collections

· Accounts Receivable

DUTIES AND RESPONSIBILITIES:

The following list some of the major duties and responsibilities Billing and Collections Department.

_____1. Insurance Verification. Verify coverage for new patients.

_____2. Re-verify coverage on insurance changes for established patients.

_____3. New Patient Info. Complete new patient information sheet, signed by the patient. Including HIPAA information.

_____4. Financial Consultation. Explain benefits to patients and have them sign Verification Form, Assignment Form and Medicare Disclosure Form as appropriate.

_____5. New Patient Data. Enter new patient information into computer system.

_____6. Daily Charges. Assist with the daily entering of day sheets.

_____7. Patient Billing Data. Make any necessary changes to established patient files (name, address, phone number, insurance changes, etc.).

_____8. Insurance billing. Batch bill of insurance claims bi-monthly, on the 1st and the 15th.

_____9. Patient Statements. Cash billing, patient statements, bill on or around the 25th,

_____10. HMO/PPO. Bill HMO and PPO monthly.

_____11. Post insurance payments. Attach copies of insurance checks and EOB's (Explanation of Benefits) to their respective claims and file them after they have been posted to patient accounts.

__a. Bill patients for their deductibles, co-payments and disallowed services.

_____12. Financial consultation. Do a thorough financial consultation on each patient after their report of findings, after insurance changes, after active care and conversion to wellness care, or any other time as appropriate.

_____13. Review Accounts Aging Report Each month.

__a. Review each type of account, such as PI, Major Medical, Medicare, overdue accounts, cash accounts, work comp accounts, etc.

__b. Call on any claim that is over 30 days old.

__c. Follow-up on cash accounts where no payment has been made in within 30 days.

__d. Contact patients with overdue accounts and setup a payment plan and monitor these plans closely.

_____14. Every three months, review general office financial policies to ensure they are current for applicable. Oversee financial consultations and financial arrangements made with each patient, ensuring that all needed liens, assignments, etc., are executed.

_____15. Communicate with doctors regarding problem accounts.

_____16. Supervise front desk collections and ensure that patients make their agreed financial commitments.

_____17. Ensure that the clinic is legally covered by keeping current on insurance laws and changes in insurance practices, and by seeing that all policies and written financial procedures are being followed.

Payment Types

_____18. Cash Patients.

__a.

_____19. Hardship Patients.

__a.

_____20. Personal Injury.

__a.

_____21. Worker's Compensation.

__a. Sent weekly update reports on all active work comp cases.

_____22. Keep insurance log up to date.

_____23. Medical necessity requests completed within three business days of receipt.

_____24. Ensured 15 financial packets for each pay type on hand at all times.