Describe what HIPAA requires.
Discuss how protected health information can be recognized.
Identify situations in which information can be disclosed without consent.
Describe penalties for HIPAA noncompliance.
Identify instances when a parent of a minor may not have access to health information.
Identify individuals considered business associates under HIPAA.
Explain how to create or maintain financial arrangements with patients or the responsible party.
Demonstrate how to maintain patient account records including a record of all charges, payments, and adjustments to the account.
Understand why patients should be provided with a receipt or walkout statement.
Verify day-end totals for all charges, payments and account adjustments.
Show how to prepare a daily bank deposit of all receipts.
Verify that daily totals have been accurately carried over to the monthly summary.
Explain how to generate patient account statements on a regular basis.
Demonstrate how to prepare and verify month-end accounts receivable and related management reports.
Explain how to handle delinquent accounts.
Understand and describe the different methods of third-party payments including: UCR, schedule of allowances, DMO, HMO, IPA, PPO, direct reimbursement and capitation programs.
Understand and be able to explain insurance coverage to a patient and formulate financial arrangements accordingly.
Demonstrate how to prepare and submit pre-treatment estimates and claims to third-party carriers.
Explain how to follow-up on delayed, lost, and/or rejected third-party claims.
Explain how to determine eligibility of benefits.
Describe the birthday rule.
Give an example of an alternative benefit policy.
Explain dual coverage, primary and secondary carriers.
Give an example of a non-duplication of benefits scenario.
Understand the CDT code categories.
Describe advantages of electronic claims submission.
Understand the difference between release of information and assignment of benefits.
Explain what a pretreatment estimate is, and what factors can affect the estimate.
Give examples of reports for tracking claims.
Identify key information on an EOB.
Understand what actions can constitute fraud.
Understand how to differentiate between invoices and statements.
Demonstrate how to verify a packing slip.
Describe how to manage expense records by appropriate categories.
Discuss how to balance a checkbook.
Explain how to reconcile bank statements.
Discuss how to manage the petty cash fund.
Explain what information is required for payroll deductions.
Explain how long payroll records should be maintained for tax and government purposes.
Explain how to establish and maintain an inventory system to assure adequate quantity of supplies in the most cost-effective manner.
Demonstrate how to determine the reorder point and reorder quantities of consumable supplies.
Explain how to order supplies in accordance with practice policies.
Discuss the different types of inventory systems.
Differentiate between expendable, non-expendable and capital items.