Select a provider or health care facility coder/biller to interview and review the process they go through to satisfy reimbursement requirements for billing purposes.
Write a paper of 750-1,000 words that describes the processes that are utilized in producing a final bill. Include in the paper:
How health care charging and pricing processes are different from those in other industries.
How private and government insurers and payers impact actual reimbursement.
Cite a minimum of three references to support your rationale.
Related posts:
- For this Discussion, you will investigate how another organization conducts assessments. Begin by finding out whatever you can through Web searching about your local or state health department's approach to assessment and strategic planning. Find out also if there are initiatives at the state level to coordinate health assessments from the various communities in the state. If so, are there tools and forms available to do that? (See the Iowa state Web site as an example: http://www.idph.state.ia.us/chnahip/reports_2005.asp.) Then locate and interview someone who has been involved in community health assessment and strategic planning at either a local or state level. To find a person to interview, contact your local health department. Depending on the size of the department, you may wish to ask to interview the director or else ask to be referred to someone who has participated in assessment and strategic planning. If you prefer, you could instead call your state health department; each state should have personnel who deal with coordinating strategic plans from individual counties, and one of these individuals might be a good person to interview. Your interview may be conducted over the phone or via e-mail, or in person if you prefer. (Note: You must transcribe or summarize your interview and post it.) Prepare your thoughts and questions carefully in advance so you can be succinct in your interview. In your interview, you should ask them questions along these lines, as well as any other questions you think are appropriate to the organization or individual you are working with: 1. How do you assess the needs of your community? How often do you conduct assessments? 2. What use did you make of the assessment data? Did you develop a strategic plan or something similar for your department and/or for the community? Please describe this plan. (For example, how detailed is it? Is it a long-range plan?) 3. What are your thoughts about the assessment process? How well is it working? What are specifc strengths of the process from your perspectives? Any barriers or difficulties to overcome? Then: # Identify the organization and title of the person you contacted (for privacy purposes, however, do not identify the name of the person you interviewed). # Summarize the findings of your interview, highlighting what you found most surprising or interesting regarding the challenges and benefits of the community health assessment process. Is there anything you would do differently or do you have suggestions for improvement? # Post a transcript or detailed summary of the interview as an attachment; this will allow other students who are interested to learn more about this organization's assessment process.
- Current Trends and Issues in Managed Care: Managed care hospital reimbursement Managed care provider reimbursement
- What do you believe are the primary advantages and disadvantages of having multiple revenue sources for health care services offered by an organization for planning and reporting purposes? 2nd assignment This assignment will require you to consider several influences to the budgeting process of a health care institution. Here, you will review payer mix and other influences to revenue as you consider revenue factors for the budget.
- Imagine you are considering the possibility of operating a small business or practice related to health care, either as a provider of some sort of care or as a service intended to support various provider organizations in their care-delivery activities.
- What legal risks are present when entering into and working under a health care contract? How would you ensure that a health care contract meets all legal requirements to be valid? How can you avoid ethical issues in meeting contract requirements?
- Criteria to be looked at to determine which home health, skilled nursing facility, hospice, or long term health care facility to use to send patients.
- Coder Interview
- Coder Interview
- Analyze the requirements of the CMS 2009 Environment of Care Skilled Nursing facility Guidance and its intended impact on long-term care resident.
- Analyze the requirements of the CMS 2009 Environment of Care Skilled Nursing facility Guidance and its intended impact on long-term care resident.