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1.      Set up a ledger card for established patient Helen Rice (DOB

1/17/58), 212 Hemmingway Road, Woodland Hills, XY 12345; home telephone number: (555) 486-7721; work telephone number: (555) 486-3333; insured with QRS Insurance Company, policy No. QRS 212345-678.

        Enter balance forward of $360.00.

2.      Enter the charge for a Level IV office visit on 3/16/XX with proper reference and description; compute a running balance, office visit costs $61.51, ref# 99214..

3.      Enter a notation that the insurance company was billed on 3/17/XX for these services and bring down the balance.

4.      Post the patient payment (check No. 987) on 3/20/XX in the amount of $360 for amount owed; compute a running balance.

5.      The bank calls, stating check No. 987 is being returned for nonsufficient funds (NSF). Post a reversal of the payment and calculate a new running balance. The patient is called and asked to bring in cash or a money order within three days.

6.      On 3/30/XX, you receive notification from the insurance company that the patient no longer has insurance coverage. Bill the patient for the entire balance and make a notation on the ledger; bring down the running balance.

7.      On 4/30/XX, you send a second statement to the patient indicating "Account is overdue, please pay balance." Make an entry on the ledger and bring down the running balance.

8.      On 5/30/XX, you send a third statement to the patient indicating "If payment is not received in five days, your account will be sent to a collection agency." Bring down the running balance.

9.      On 6/5/XX, you send the account to the Collect 4U Agency. Make a notation on the ledger; adjust the entire balance (subtract it from the running balance), circle it, and post a zero balance.

10.   On 7/15/XX, the patient pays the collection agency $200. The agency sends check No. 9876543 to the office. Post the agency check on the patient's ledger, reverse the adjustment by $200, and indicate account closed.

STATEMENT


PRACTON MEDICAL GROUP, INC.

4567 Broad Avenue

Woodland Hills, XY 12345

Tel. 555-486-9002

Fax No. 555-488-7815







Phone No. (H) _________________________ (W) _____________________ Birthdate_____________

 

Insurance Co. ___________________________________________________ Policy No.____________

 

DATE

REFERENCE

DESCRIPTION

CHARGES

CREDITS

 

BALANCE

PYMTS

 

ADJ

BALANCE FORWARD                                                         

 

 

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