Front Desk With Question & Answer Guide (With Explanation)

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What This Question Is About

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How to Approach This Question

Focus on explaining concepts clearly and supporting them with examples.

Key Explanation

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Original Question

You are the at the front desk with a patient who is checking out after a medical visit. The patient insists that he “does not need to pay the copayment” because the “doctor is a friend.” The physician participates with the patient’s insurance company and you know that NOT collecting the copayment would be considered fraud as noted in the contract. Although you have explained to the patient that you must collect a copayment, he is insistent that the “doctor” does not want him to pay for this visit. Do you think the receptionist handled this situation appropriately? Why or why not? Describe how you could communicate this patient’s request to the physician as well as the insurance requirements. Be specific. DO NOT refer this to the office manager https://ensemble.sinclair.edu/hapi/v1/contents/permalinks/Professional_Fees/view “PROFESSIONAL FEES” FADE IN: RECEPTION AREA AT DOCTOR LEAVEMCOLD’S OFFICE JUDY is sitting behind her reception desk when Mr. IMAPAL approaches from the side or behind after just completing a visit with Dr. Leavemcold. JUDY: Hello Mr. Imapal. Is Dr. Leavemcold completely finished with your check-up now? MR. IMAPAL Yes he is. And I might add that it looks like I passed with flying colors. Man, there sure are a lot of tests during these five-year check-ups! JUDY Yes there are. And some of them are literally a pain in the butt. JUDY smiles as she takes pride in making a funny. MR. IMAPAL winces in response as he says: MR. IMAPAL Ouch. Don’t remind me. JUDY (chuckles a bit and continues joking) You’re just lucky you know the doctor so well. He’s been known to be downright cruel to some of his new patients. MR. IMAPAL (Boasting, almost arrogantly) Yes, I guess being a close personal friend of Dr. Leavemcold does have its advantages! JUDY (facetiously) Yes, but those are largely offset by ….being… a…close personal friend of Dr. Leavemcold. Script 2: Professional Fees 1 But I digress. I suppose it’s time now to pay your bill. MR. IMAPAL I suppose it is. And I don’t mind a bit since I’m pretty sure my insurance will cover it all! JUDY Well, not all of it. You still need to take care of the co-pay. MR. IMAPAL Oh contraire, Pierre. Dr. Imapal told me I wouldn’t have to pay the copay….on account of us being such good friends and all. Did I ever mention I once saved his life by pulling him out of a lake? JUDY Uhhh…no, you didn’t. But that doesn’t change the fact that Dr. Leavemcold is a participating provider with your insurance company and is required contractually to collect your copayment. I’m afraid you’ll HAVE to pay it. MR. IMAPAL It doesn’t really matter to me what you have to do on your end. All I know is that Dr. Leavemcold told me he would cancel my copayment as a professional courtesy. Did I mention I once not only pulled the doctor out of a lake, but also helped pull his car out? A concerned look comes over JUDY’s face. JUDY Uhh…again…no, you didn’t. But what I’m trying to make you understand is that, thanks to managed care, professional courtesy discounts are pretty much a thing of the past. Since Dr. Leavemcold has a contract with your insurance company, billing for your office visit is considered fraud without also collecting your copay. MR. IMAPAL Yes. Yes. I think I understand what you’re saying. But what I’m trying to make you understand is that Dr. Leavemcold and I are like this Mr. IMAPAL holds his hand up and crosses his fingers to illustrate. MR. IMAPAL We are VERY…close…friends. Did I mention I once told the investigating officer that I drove the car into the lake… since I was pretty sure Dr. Leavemcold wouldn’t pass the sobriety test? JUDY’s face freezes as the full import of Mr. Imapal’s comments sink in. JUDY Oh. I see. Let me just run this by the doctor to see if he’s OK with writing off the whole visit. MR. IMAPAL (with a smug smile) Yes. Please do. FADE OUT IN YOUR SCRIPT, JUDY’S LAST LINE WAS: Well, that’s very interesting, but I’m sure you wouldn’t want Dr. Leavemcold to commit insurance fraud and be subject to the penalties under the law, including the possibility of going to jail and losing his medical license, now would you?

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