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Medical Office Accounting Procedures: Essentials for Effective Patient Billing

This chapter focuses on essential accounting procedures in medical offices, including basic accounting principles and the application of the pegboard and Medisoft systems for patient accounting. You'll learn how to record transactions, apply charges and payments from both patients and insurance companies, and print necessary claims and patient statements. Key concepts include cash-basis vs. accrual-basis accounting, daily journals, patient ledgers, and batch payments. Enhance your skills in medical office billing and improve financial management practices in healthcare settings.

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Medical Office Accounting Procedures: Essentials for Effective Patient Billing

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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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