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Complete Procedure using attached template.
1. For new patients, create the patient account by entering the following information on a patient account ledger card:
a. Patient’s full name, address, and at least two contact phone numbers
b. Date of birth
c. Health insurance information, including the subscriber numbers, group number, and effective date
d. Subscriber’s name and date of birth (if the subscriber is not the patient)
e. Employer’s name and contact information.
2. For returning patients, review the account record to see whether a balance is due. If there is a balance, bring this to the patient’s attention when he or she comes for the appointment (include this in the ledger summary referenced below). Respectfully explain that the provider would appreciate a payment on the previous balance before he or she can care for the patient. Then complete the encounter form, including all procedures and the associated fee schedule.
3. Total all the charges on the encounter form for the services rendered.
4. Then subtract the copayment made from the total charges. The previous balance, if any, is added to this new total.
5. Please write a brief collaborative report (150-200 words) on each ledger.
Kinn’s The Medical Assistant, 13th Edition
Chapter 16: Patient Accounts, Collections, and Practice Management
PROCEDURE 16-1: PERFORM ACCOUNTS RECEIVABLE PROCEDURES FOR PATIENT ACCOUNTS: CHARGES
Scenario 1: Ken Thomas is a returning patient of Dr. Martin. He is being seen for hypertension (ICD-10-CM;I10). He makes his $50 copayment at the time of the office visit.
BLUE CROSS BLUE SHIELD
1234 Insurance Place
Anytown, Anystate 12345-1234
Claim Number:
1-99-16987087
Group Name:
ABC Company
Group Number:
55124T
Employee:
Ken Thomas
Patient:
Ken Thomas
SSN:
783212215
Prepared by:
M. Smith
James Martin, M.D.
Prepared on:
07/04/20XX
Walden-Martin Family Medical Clinic
1234 Anystreet
Anytown, Anystate 12345-1234
PATIENT RESPONSIBILITY
Amount not covered:
0.00
Co-pay amount:
0.00
Deductible:
0.00
Coinsurance:
64.61
Patient’s Total responsibility
64.61
EXPLANATION OF BENEFITS
DOS
CPT/HCPCS
Charge
Amount
Not
Covered
Reason
Code
PPO
Discount
Covered
Amount
Ded
Amount
Copay
Paid
at
Payment
Amount
06/03/20XX
99204
250.00
0.00
48
136.00
114.00
0.00
0.00
80%
91.20
06/03/20XX
94375
40.00
0.00
48
0.00
40.00
0.00
0.00
80%
32.00
06/03/20XX
94060
75.00
0.00
48
0.00
75.00
0.00
0.00
80%
60.00
06/03/20XX
94664
50.00
0.00
48
0.00
75.00
0.00
0.00
80%
38.76
06/03/20XX
94760
50.00
0.00
48
4.40
45.60
0.00
0.00
80%
36.48
TOTAL
465.00
0.00
141.95
323.05
0.00
0.00
258.44
Total Payment Amount
258.44
CBT CODE
Reason Code
99204
OFFICE/OUTPT VISIT E/M NEW MOD-HI SEVERIT
48 CON DISCOUNT/PT NOT
RESPONSIBLE
94375
RESPIRATORY FLOW VOLUM LOOP
94060
BRONCHOSPSM EVAL SPIROM PRE and POST BRON
94664
AEROSOL/VAPOR FOR INHAL; INT DEMO and EVAL
94760
NONINVASIVE EAR/PULSE OXIMETRY-02 SAT
If you have any questions, call Blue Cross Blue Shield at (800) 255-9091
Ledger:
Blue Cross Blue Shield
ID # KT4496785
Group # 55124T
Subscriber:
Ken Thomas
Ken Thomas
398 Larkin Avenue
DOB:
10/25/1961
Anytown, Anystate 12345-1234
Date
Service Description
Charges
Payments
Adjustments
Balance
06/03/20XX
99204
250.00
250.00
06/03/20XX
94375
40.00
290.00
06/03/20XX
94060
75.00
365.00
06/03/20XX
94664
50.00
415.00
06/03/20XX
94760
50.00
465.00
Ledger Summary:
Scenario 2: Martha Bravo is seeing Dr. Walden for the first time for hypothyroidism (ICD-10-CM; E03.9). She makes the $30 copayment at the time of the office visit.
Name:
Martha Bravo
Address:
1234 Anywhere Station
Anywhere, Anystate 12345
Contact #1:
(212) 555-1212
Contact #2:
(212) 555-1313
Emergency Contact:
John Bravo (212) 555-2627
SSN:
111-22-3333
DOB:
1/23/56
Health Insurance Information:
Carrier: Aetna
Subscriber: Martha Bravo
Subscriber DOB: 1/23/56
ID #: XEK3332328748
Group #: X1000
Effective Date: 1/1/20XX
Employer Information
Name: Malibu Gardening
Contact: (212) 555-5151
Ledger:
Health Insurance Carrier:
ID #:
Group #:
Subscriber:
Patient name
Address
DOB:
Date
Service Description
Charges
Payments
Adjustments
Balance
Ledger Summary:
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