Financial_Policies

CheckPoint: Effective Financial Policies and Procedures • Resource: Figures 15.1 & 15.2 on pp. 485–486 of Medical Insurance • Post a 350- to 400-word response to the following: The three major elements to critical thinking are logical inquiry, problem solving, and evaluative decision making. In this CheckPoint, you must exercise critical thinking skills to answer the following questions: • Medical offices must have financial policies in place to manage patient and insurance payments and to keep track of paid and unpaid for services. o What are the basic elements of an effective medical office financial policy' o Effective medical office financial policies must be sound and clear. The policy must explain the patients’ responsibilities for paying, as well as setting up billing and/or collection procedures. Effective financial policies also are easy for patients and the medical office staff to understand and follow. Medical office staff must be able to clearly understand the financial policy so that they may ensure that the patients clearly understand the financial policy. The staff must be aware of what is expected from the patients and they must be able to explain to the patients what their responsibilities are. Effective financial policies must also address all possible scenarios regarding payments. Financial policies should address to patients how the office will handle collection of payments, copayments, deductibles, balances, and any past due balances, financial payment arrangements for unpaid balances, if applicable, charity care or discounted services for low income patients, payments for non covered services, prepayment for services, date of service discounts, or discounts for patients with financial need, acceptable forms of payment such as cash, credit card, debit card, etc, and nay special circumstances for car accidents, or no insurance. o In what ways do medical office procedures support financial policies' Give Examples. o Medical office procedures must support financial policies. For example, if the financial policy states that only cash or check can be accepted as payment, then the office procedure must also follow that. If the office procedure says that credit, or debit cards may be accepted as payment, there will be confusion, and it could result in the services not being paid for. Financial and office procedures must follow each other. As long as they do, then the billing process can operate effectively and efficiently. o What are the consequences when office procedures do not support the financial o policy' o When office procedures do not support the financial policy, then the billing and/or collections process does not operate smoothly. Also, if office procedures and policies do not support the financial policy, then there can be instances where services are not paid for. o What recommendations, strategies or tools can medical offices use to ensure effective alignment of policies and procedures' o In order for office polices and financial policies to follow each other, it is important that staff members communicate when constructing said policies. It is also important that efforts are made by staff to educate the entire staff on both types of polices, and what to do if there is a conflict. There should be strategies in place to handle conflicts in policies and ways of resolving conflicts and ensuring proper procedures are followed so that all services are paid for and there are no resulting financial shortfalls.