PATIENT SCHEDULING
What are patients instructed when they call into the office for an appointment?:
What is the office visit payment policy?
When is the patient's insurance information first obtained?
When is insurance verified:
PATIENT CHECK IN
Are patients required to sign in: __ yes __ no; if yes, is the sign in sheet maintained as a permanent office record: __ yes __ no
How does the office find out if a patient's insurance coverage has changed since the last visit:
Does the office make a copy of the patient's insurance card: __ yes __ no
Does the office make a copy of the patient's driver's license: __ yes __ no
Does the office document and track where new patients come from: __ yes __ no. If yes, how:
Is new patient demographic information inputted into the computer before a patient is escorted to the exam room? __yes __no. If no, please explain:
PATIENT CHECK OUT
Does the doctor complete all information on the charge ticket? __yes __no
If the patient is on a managed care plan, how does the front desk know how much to collect as a copayment from each patient?
When the patient checks out, is all the charge and payment information entered into the computer before the patient leaves the office? __yes __no. If no, explain why not:
If the patient has an overdue balance, is there an attempt to collect this amount from the patient while the patient is in the office? __yes __no. If no, explain why not:
If the patient is scheduled for surgery, does the office attempt to collect a surgical deposit? __yes __no
Do patients receive any type of financial counseling before the procedure is performed? __yes __no
When a patient checks out after the office visit is complete, does the front desk (or check out desk) attempt to collect full payment, deductibles, and/or copayments? __yes __no
BILLING
Explain how the office communicates inpatient (generally hospital) charges to the office so that the office can bill these services to the patient’s insurance carrier.
How are surgical or procedural charges captured so they may be billed properly and timely?
How often are insurance claim forms filed each week?
Are operative notes attached to claim forms when they are filed with an insurance company? __yes __no; If yes, detail situations when operative notes are attached:
Does the doctor dictate notes on a timely basis? __yes __no; If no, how long does it take and explain why.
Does the practice utilize electronic billing? __yes __no; If no, explain why.
Are insurance claim forms held for any reason? __yes __no; If yes, explain situations when this occurs.
How accurate is the front desk or other personnel in obtaining the patient’s insurance information?
How are charge denials handled in the office?
COLLECTIONS
When does the practice begin following up on unpaid insurance claim forms?
What is the practice’s follow up procedure for unpaid insurance accounts?
How does the office follow up on unpaid patient receivables and how often?
When are patient account statements mailed out?
Are collection letters used by the practice? __yes __no; If yes, how often are they sent out and what types of collection letters are sent.
Does the practice use a collection agency? __yes __no; If yes, how often are accounts sent to the collection agency?
Does the practice routinely review a detailed aging of the accounts receivable? __yes __no
[PRINTER FRIENDLY VERSION]
