Alert Office Economics

Copyright © 1996-1998 R. C. Schafer, DC, PhD, FICC



Table of Contents

INITIAL CONSIDERATIONS -- 12

UNDERSTANDING THE DOCTOR'S FEE -- 13
Standardized Fees -- 14
Care-Basis Fees -- 14
Unit-Basis Fees -- 15
Prepaid Fees -- 15
HMOs -- 15
Discounted Services -- 15
Professional Courtesy -- 16
Other Professional Guidelines -- 17
Trading Services -- 18
Hardship Cases -- 18
Cash-Basis Fees -- 19
Patient Credit -- 20

EXPLAINING FEES TO PATIENTS -- 24
Basic Economic Management -- 25
A General Approach -- 28

ANSWERING QUESTIONS ABOUT FEES AND SERVICES -- 28

DISMISSING THE PATIENT -- 32

OFFICE ACCOUNTING -- 32
Basic Requirements -- 32
The Communication Loop -- 34
Deferred Collections and Accounts Receivable -- 34
Third-Party Payments -- 36
Selecting the Proper System -- 36
Pegboard systems -- 36
Super bills -- 37
Entry systems -- 38

THE OFFICE BOOKS -- 38

ACCOUNTS RECEIVABLE AND BILLING -- 39
Visit Slips -- 41
Day Sheets and Summary Sheets -- 42
Patient Ledger Card -- 47
Posting -- 47
Family cards -- 47
Combined history and ledger forms -- 48
Recording Payments and Receipts -- 48
Personalized Receipts -- 49
Accounts Receivable Insurance -- 49
Statements -- 50
Deposits -- 51
Summary of the Mechanics -- 52
Payments received in the mail -- 53
Balancing Accounts Receivable -- 53

BILLING ROUTINES -- 55
Professional Considerations -- 55
Ethics -- 55
Discretion -- 55
Understanding -- 55
Attitude in Approach -- 56
Billing Mechanics -- 58
Processing -- 58
Timing -- 59
Reminder systems -- 59
Tracing a "skip" -- 59
The Problem of Discounting Fees -- 61

COLLECTION ADMINISTRATION -- 61
Collection Problems -- 61
Coping with Delinquent Accounts -- 62
Avoid Unprofessional Procedures -- 63

COLLECTION ADMINISTRATION -- 64
Collection Management -- 64
Supervising effective collections -- 65
Time payments and late payments -- 65
Preventive bad-debt screening -- 67
Accounts receivable aging -- 67
Past-due account follow-up -- 68
Evaluating collection efforts -- 70
Computing office collection rate -- 71
Statement Services -- 73
Collecting by Telephone -- 73
Technique -- 74
Summary of highlights -- 80
Collecting by Office Letters -- 82
Sample first notices -- 84
Sample second notices -- 84
Sample third notices -- 85
Sample final notices -- 86
Registered mailings -- 88
Sample follow-up letters -- 88
Collection Letter Services -- 88
Collection Agencies -- 89
Legal Action -- 92
Canceled Accounts -- 93
Computerized Billing Services -- 93

ACCOUNTS PAYABLE -- 95
Checking Accounts -- 96
Daily Disbursement Record -- 96
The General Ledger -- 99
Bills and Invoices -- 99
Deliveries -- 100
Credit Memos -- 100
Credit Adjustments -- 100
Outside Laboratory Charges -- 100

PETTY CASH -- 101

EXTRA CASH -- 102

RECONCILING BANK STATEMENTS -- 102

FINANCIAL CONTROL -- 103
Periodic Financial Responsibilities -- 103
Condensed tax form timetable -- 104
Payroll Records -- 105

MANAGING THE DOCTOR'S PERSONAL ACCOUNTS -- 105

PRACTICES CAN GET SICK TOO! -- 106
Goal Setting and Achievement: Personal and Professional -- 109
The Art of Practice Development -- 112
Patient classifications and codes -- 113
Sustaining practice growth -- 115
The Referral Practice: Key to Economic Growth -- 116
Characteristics of a positive philosophy -- 118
Motivational communications -- 121
Periodic Fee Evaluations -- 124
Setting a fee schedule -- 124
Cost analysis -- 126
Time analysis -- 126

SUMMARY OF HUMAN RELATIONS IN OFFICE ECONOMICS --128
Explaining Fees to Patients -- 128
Collections of Overdue Accounts -- 130
Dollars and Sense -- 132
The value of itemized statements -- 133
Communicating the facts -- 134

WORKING WITH AN ACCOUNTANT -- 134
Control of Billing and Cash Receipts -- 135
Control of Cash Disbursements and Payroll -- 135
General Bookkeeping System -- 136
Preparation and Analysis of Financial Statements -- 136
Collection of Accounts Receivable -- 138
Tax Reporting and Planning -- 139
Banking Relationships and Investment Decisions -- 139
Doctor's Estate Planning -- 140
Selecting an Accountant -- 140