Ledger Cards For Medical Assistants

It is, of course, necessary to maintain a record of services provided and charges and payments for each individual seen in the office or hospital. This is accomplished by creating a separate ledger for each patient household. In order to easily keep track of patient accounts there should be a responsible party for each family whose name and address will appear in the mailing window at the top of the ledger card (Figure 17- 3). Services or payments for any other members of the family seen in the office or hospital will be entered on the same ledger and the patient's first name (or coded number) will be written in the space provided (reference space columns). If the office is doing insurance billing or receiving insurance payments, it is extremely important that charges and credits be applied to the correct family member so never omit this step when making entries.    

The columns on the front of the ledger card will show the date of activity, name of patient, a clear description of type of activity, amount of charge or credit, adjustments (if any), and the family's total balance due.    
The back of the ledger card in Figure 17-3 includes all pertinent patient and insurance information needed for collection purposes.    
The ledger is placed under the charge slip or receipt, directly on the day sheet, and aligned prior to posting. Never post any patient entry without the patient's ledger in place. This prevents recording information on the day sheet and thus omitting it inadvertently from the patient's ledger.

Charge Slips and Receipts    

The charge slip (or superbill) shown in Figures 17-1 and 17-4 is a three-part form that:    
1. Provides patients with a record of account activity for the day    
2. May eliminate the need for separate insurance forms    
3. Provides the office with a copy of that day's services, which will be filed in the individual's chart    
Charge slips can be ordered to fit the practice. Information on the charge slip includes not only the amount of the day's transaction, but procedure codes and diagnosis codes that satisfy the requirements for most insurance companies to reimburse the patient or physician. When the slips are ordered, the office will indicate the most common services provided, which will be printed on the form with the applicable procedure codes (and some blank lines for infrequently used procedures). After seeing the patient, the physician places a check mark beside the services rendered. In addition, there is an area for the diagnosis code to be filled in by the physician at the same time. The charge slip is printed with the name, address, and telephone number of the practice.    
Unlike charge slips, the receipt forms (Figures 17-1 and 17-5) used for payments on account are not customized other than to have the name, address, and telephone number of the practice preprinted. The receipt form is only used when someone makes a payment on account and no services are rendered that day. There is only one copy of this form, which is given to the patient after the payment is recorded. Like many charge slips, the receipt form may include a space to write in the date of the patient's next appointment. It is not necessary to keep any other record of the transaction, since it is entered on the day sheet and ledger card at the time the receipt is filled out using the write-it-once procedures.