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Chapter 4

Chapter 4. Chapter 4 Medical Office Accounting Procedures. Learning Objectives. Understand basic accounting principles. Understand the pegboard system of patient accounting. Apply charges to a patient in Medisoft . Apply payments from patients and insurance companies into Medisoft.

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Chapter 4

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  1. Chapter 4

  2. Chapter 4Medical Office Accounting Procedures

  3. Learning Objectives • Understand basic accounting principles. • Understand the pegboard system of patient accounting. • Apply charges to a patient in Medisoft. • Apply payments from patients and insurance companies into Medisoft.

  4. Learning Objectives (cont’d.) • Apply a batch payment from an insurance company. • Print insurance claims. • Print patient statements.

  5. Chapter 4 Lesson 4.1

  6. Basic Accounting Principles Accounting: • System for recording all transactions for the medical office Bookkeeping: • The recording part of the accounting system Accounting equation: • Assets - Liabilities = Owner’s Equity

  7. Basic Accounting Principles (cont’d.) Types of accounting: • Cash-basis accounting: recording revenues when cash is received • Accrual-basis accounting: revenue is recorded when services are performed

  8. Basic Accounting Principles (cont’d.) Daily journal: • Used to record daily transactions in chronological order Patient ledger: • All the transactional information for a patient Posting: • Transferring transaction information from the journal to the patient ledger

  9. Pegboard System Pegboard system: • Manual accounting system • One-write system Day sheet: • Lists all the transactions for a given day

  10. Pegboard System (cont’d.)

  11. MedisoftAccounting System Medisoft: • Accounting software package • All transactions are tied to a case • The transaction area has three areas: • Top area is demographic and insurance information • Middle area lists charges • Bottom area is for payments

  12. Charges and Payment Screen

  13. Chapter 4 Lesson 4.2

  14. Applying Patient and Insurance Payments Medical offices receive two types of payments: • Insurance company payments • Patient payments

  15. Applying Patient and Insurance Payments (cont’d.)

  16. Patient Payments Apply Patient Payment: • Apply patient payments by selecting Transaction Entry from the Activities menu • Select the patient • Select New in the payment area • Make sure to press the Apply button when finished

  17. Patient Payments (cont’d.)

  18. Printing Insurance Claims • To bill and receive reimbursement from insurance, a claim must be submitted. • Creating claims in Medisoft is done through the Claim Management from Activities menu

  19. Printing Insurance Claims (cont’d.)

  20. Insurance Payments • Provider usually receives one payment for several patients covered by a particular insurance company. • Claims are itemized in an EOB (explanation of benefits).

  21. Explanation of Benefits (EOB)

  22. Insurance Payment • Insurance companies pay only what has been contracted with the provider. • Most contracts don’t allow the provider to charge the patient the difference.

  23. Insurance Payment Screen

  24. Insurance Payment Screen (cont’d.)

  25. Printing Patient Statements Patient statement: • List the amount owed to the medical office • List procedures performed at time of visit Two most common billing methods: • Once-a-month billing • Cycle billing

  26. Printing Patient Statements (cont’d.)

  27. Printing Patient Statements (cont’d.)

  28. Printing Patient Statements (cont’d.)

  29. Printing Patient Statements (cont’d.)

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