Introduction: In order to properly code a bill for medical necessity, it is important to understand different plans and the requirements for billing each. It is true that they all use the ICD-10-CM diagnosis coding system, the CPT procedure coding system, and the CMS-1500 form, but each type of carrier has certain requirements for a […]
Questions
TRICARETRICARE
Introduction: TRICARE is the healthcare provider for active or retired military personnel. It also covers the family of these persons. There are a variety of plans and qualifications that go along with this coverage. In order to understand TRICARE, it is important to understand the benefits available and to whom they are available. Tasks: […]
Medicare and MedicaidMedicare and Medicaid
Introduction: Medicare and Medicaid are federal programs that cover a large proportion of the US population with healthcare. The two have similar objectives in the area of providing care, but there are significant differences in them that concern reimbursement. Tasks: Describe each program, Medicare and Medicaid. Provide the major features of each program. Discuss […]
Supporting Lectures:Commercial InsuranceSupporting Lectures:Commercial Insurance
introduction: Commercial insurance ranges from individual health coverage to automobile liability coverage. All commercial policies have similarities and differences, and there are critical areas to address in billing for each type. Tasks: Describe at least three commercial insurance programs. Provide the major features of each program. Discuss how these programs differ from each other. […]
Supporting Lectures:Supporting Lectures:
Introduction: In order to properly code a bill for medical necessity, it is important to understand the electronic medical record. This record contains information about the patient’s health both before and after the treatment and has the data needed to assure a payer that the treatment was necessary. Tasks: Explain the contents of the […]
Supporting Lectures:Supporting Lectures:
Introduction: The Prospective Payment System of CMS consists of thirteen schedules that allow the calculation of payment for a patient encounter. The DRG or price-based system covers inpatient charges from one of these schedules. Tasks: Describe the schedules of CMS. Provide an example of a charge for each schedule. Describe the case mix concept […]
Introduction:Introduction:
Claims management is the art of consolidating, billing, filing, revising, and managing medical claims, an imperative aspect of the healthcare industry. Medical facilities cannot receive due funds if patients are unaware of how much they need to pay. Ensuring provider organizations understand the fundamentals of medical billing and coding can help providers and other […]
Supporting Lectures:Supporting Lectures:
Review the following lecture: Legal and Regulatory Issues Introduction: The 1986 Health Care Quality Improvement Act established a database that is intended to improve the quality of healthcare in this country. Two other databases have merged with it and now offer many potential advantages. Tasks: Describe the National Practitioner Data Bank (NPDB). Identify the […]
Cover Letter and ResumeCover Letter and Resume
You want to apply for the position of Human Resources Director with a Fortune 1000 company in the field of retailing. The company “would prefer” applicants with at least four years of experience, though others can also apply. You are six months short on the preferred experience. However, you are absolutely confident of yourself […]
Writing Appropriate E-MailsWriting Appropriate E-Mails
Given below is an example of a poorly written e-mail. To: Sylvia Greene ([email protected]) From: Chester Goings ([email protected]) Subject: No Go on Baby Charity Thing Cc: Bcc: Hey, Syl, you’re one in a million. But we can’t give you time off to work on that charity fashion show/luncheon thingy you want to coordinate. And […]