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What else can I help you with?
Why do charges need to be adjusted for patients who are covered under a capitated insurance plan?
Because they are not being charged on specific procedures. Under a capitated plan a flat fee is paid to the physician no matter how many times a patient receives treatment.
When a patient has a credit balance on his or her account what adjustment is posted to the account?
When a patient has a credit balance on their account, a refund adjustment is typically posted. This adjustment reflects the amount overpaid by the patient, which may result from overpayments, insurance adjustments, or billing errors. The credit balance can be refunded to the patient or applied to future services, depending on the practice's policy and the patient's preference.
What bill clause prohibits the provider from billing the patient for amounts the carrier has contractually adjusted from the physician's fees?
No Balance.
What is the medical meaning for an credit adjustment?
A credit adjustment reduces the patient's account balance. Which means money that the patient had paid and has been acredited to their balance.
How will posting an amount applied to a deductible affect the balance due on a patient account?
it reduces the balance due.
When a capitated patient's services go over a certain amount and the physician can begin asking the patient to pay fee for service this arrangement is provided in what section of the managed care cont?
it known as Stop loss limit
What are advantages of capitated payments for providers and payments?
Capitated payments offer several advantages for providers, including predictable revenue streams that can improve financial stability and allow for better resource allocation. This payment model encourages providers to focus on preventive care and efficient management of patient populations, potentially leading to better health outcomes. Additionally, it can reduce administrative costs associated with fee-for-service billing, streamlining operations. Overall, capitated payments incentivize cost-effective care while promoting a holistic approach to patient health.
What is the total of all account balances that are due to the physician called?
The total amount of all accounts that is due to a physician is simply referred to as the balance due. Care should be taken to not confuse this amount with the balance due from the patient, as opposed to the balance due from the patient as well as his or her insurance company.
What is another name for the patient account record?
ANOTHER NAME FOR THE PATIENT ACCOUNT RECORD IS THE PATIENT?
Why is a patient's medication sometimes adjusted after undergoing a pallidotomy?
Medications may be adjusted somewhat to accommodate the changes in symptoms.
Would you still see the patient if they owed a back balance?
If the patient was trustworthy and I knew the patient would pay the back balance.
When a patient account is turn over to collection agency what adjustment is posted to the account?
When a patient account is turned over to a collection agency, an adjustment is typically posted to reflect the transfer of the debt. This adjustment often includes a write-off of the account balance, indicating that the provider has deemed the debt uncollectible. Additionally, an entry may be made to show the fees associated with the collection process, if applicable. This ensures the account accurately reflects its status and any remaining liabilities.
