CRCR - Certified Revenue Cycle Representative Program Account Follow-Up and Collections Flashcards

A patient balance of $450 has been unpaid for 90 days. What is the most appropriate next step in the collections process?

Answer: Send a second collection notice and offer a payment plan

Standard collections protocol calls for escalating communication and offering payment arrangements before more aggressive action.

Which account follow-up strategy is most effective for reducing days in accounts receivable?

Answer: Working accounts by payer bucket and aging category

Organizing follow-up by payer and aging ensures the highest-priority accounts receive timely attention.

What does the term self-pay after insurance mean in collections?

Answer: The remaining balance owed by the patient after insurance has paid its portion

After insurance adjudicates a claim, the remaining patient responsibility is the self-pay after insurance balance.

Which metric best measures the effectiveness of a collections department?

Answer: Collections rate as a percentage of net patient revenue

The collections rate reflects how much of what is owed is actually collected, which is the core measure of collections effectiveness.

When a patient account is referred to an outside collection agency, what must the healthcare organization typically do first?

Answer: Provide the patient with advance notice per applicable regulations

Federal and state regulations generally require advance notice before referring accounts to outside agencies.

A collection letter is returned as undeliverable. What should the revenue cycle team do?

Answer: Use skip tracing to locate updated patient contact information

Skip tracing uses available resources to find updated patient contact information when mail is returned undeliverable.