CHAA CHAA Patient Financial Counseling and Collections 2 — Questions and Answers
Question 1: What is a payment plan agreement in the context of patient collections?
- A contract where the patient agrees to pay their balance in installments over time (Correct answer)
- A discount offered to uninsured patients
- A government subsidy for hospital bills
- An agreement between the hospital and insurance company
Correct answer: A contract where the patient agrees to pay their balance in installments over time
A payment plan allows patients to pay their balance in scheduled installments rather than in a single lump sum, making large bills more manageable.
Question 2: When collecting a copayment at time of service, which best practice should patient access staff follow?
- Wait until after the appointment to discuss payment
- Collect the copay at check-in and provide a receipt (Correct answer)
- Skip collection if the patient seems upset
- Add the copay to the final bill without collecting upfront
Correct answer: Collect the copay at check-in and provide a receipt
Collecting copayments at check-in is standard best practice and reduces the cost of back-end billing; a receipt documents the transaction for both parties.
Question 3: What is 'bad debt' in healthcare revenue cycle management?
- Balances written off because patients qualified for charity care
- Patient balances that were billed but deemed uncollectible after collection efforts (Correct answer)
- Insurance underpayments
- Contractual adjustments made per payer agreements
Correct answer: Patient balances that were billed but deemed uncollectible after collection efforts
Bad debt refers to accounts where the patient had a financial obligation but did not pay despite collection efforts, distinguishing it from charity care write-offs.
Question 4: A patient presents without insurance and asks about self-pay discounts. What should the patient access representative do?
- Tell the patient no discounts are available
- Refer the patient to financial counseling to discuss the self-pay discount policy and payment options (Correct answer)
- Charge the full chargemaster rate without discussion
- Direct the patient to go to another facility
Correct answer: Refer the patient to financial counseling to discuss the self-pay discount policy and payment options
Most hospitals have self-pay discount policies; the financial counselor can explain these options and screen for additional assistance programs.
Question 5: Which federal law requires hospitals to provide emergency care regardless of ability to pay?
- HIPAA
- EMTALA (Emergency Medical Treatment and Labor Act) (Correct answer)
- COBRA
- Stark Law
Correct answer: EMTALA (Emergency Medical Treatment and Labor Act)
EMTALA mandates that hospitals with emergency departments provide a medical screening exam and stabilizing treatment to anyone who presents, regardless of their insurance status or ability to pay.
Question 6: What is the purpose of pre-service financial clearance?
- To verify insurance after the patient is discharged
- To identify and resolve financial and insurance issues before the patient receives care (Correct answer)
- To generate final bills for submitted claims
- To assign diagnosis codes to procedures
Correct answer: To identify and resolve financial and insurance issues before the patient receives care
Pre-service financial clearance resolves eligibility, authorization, and estimated patient liability issues before service, reducing denials and point-of-service surprises.
CHAA CHAA Patient Financial Counseling and Collections 2
What is a payment plan agreement in the context of patient collections?