Tasks: Inform a patient of his/her financial obligation and demonstrate professionalism and sensitivity when discussing the patient's billing record.

Equipment and Supplies:

1. Facility's payment policy
2. Copy of patient's insurance card (or see information in the scenario)
3. Patient's account record (or see information in the scenario) .

Obtaining Payments - WMFM Clinic Policy For patients with copayments, all copayments must be collected before the patient leaves the clinic. For patients with balances overdue: Patients must pay 20% of the balance before an appointment can be scheduled. Or patients can establish a 6- or 12-month interest-free payment plan, making the first payment before the next visit can be scheduled. Payments can be made using VISA, Mastercard, personal check (no starter checks accepted), or cash. Payments can also be made online.

Scenario #1: Mr. Walter Biller arrives for his appointment. You need to check his eligibility for services and also if he has a copayment for today's visit. His insurance information: account number: 16611; Aetna, Policy/ID Number: CH8327753; and Group Number: 33347H

Scenario #2: Christi Brown is meeting with you regarding the bill she received in the mail. She called to make the appointment and she voiced her confusion about the bill. She stated that she thought her insur- ance covered everything. You check her record and see that she met her deductible and now needs to pay 20% of the billed amount. She owes $170.

Directions: Role-play the scenarios with a peer. The peer will be the insurance representative in Scenario #1, and then the patient in Scenario #2. You will be the medical assistant. You need to be professional and sensi- tive when working with patients regarding payments. You also need to follow the clinic's policy.

Steps: Scenario #1: Role-play with a peer who will be the insurance representative.

1.Contact the patient's insurance company and verify the patient's eligibility for services. Provide the representative with the patient's information. Find out if the patient has a copayment for today's visit. Document the information obtained.

Scenario #1 update: You need to provide the patient with the information that he owes a copayment for today's visit.

2. Inform the patient of his financial obligation of the copayment.

Scenario update: He states he does not have the cash with him.

3. Inform the patient of the clinic policy regarding copayments and how the payment can be made.

4.Demonstrate sensitivity and professionalism when discussing the payment. (Refer to the Checklist for Affective Behaviors - Respect and Sensitivity

Answer rating: 100% (QA)

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