CheckPoint: Payment Methods Presentation Resources: Appendix B and Microsoft® Help at support.microsoft... Due Date: Day 4 [post to the Individual forum] Prepare a 4- to 5-slide PowerPoint® presentation that describes in your own words the fee-for-service and capitation payment cycles. Include the relationship among provider, patient, and payer in your presentation and their roles in the process. Include an introduction and conclusion slide in your presentation.
Exercise: Working with CPT Modifiers Resource: Table 5.2 on p. 154 of Medical Insurance Due Date: Day 5 [Individual forum] Complete the exercise by identifying the correct CPT modifier to its corresponding procedure for the following: a.___ Bilateral Procedures b.___ Multiple Procedures c.___ Prolonged Evaluation and Management d.___ Unusual anesthesia e.___ Mandated services Post your answers to your Individual forum.
Assignment: Steps in the Medical Billing Process Resource: Figure 1.6 on p. 17 of Medical Insurance Due Date: Day 7 [post to the Individual forum] Use Microsoft® Word to prepare a 500- to 750-word paper that lists the sequence of steps in the medical billing process. In your own words, provide a 3- to 4-sentence explanation for each step. HCR 220 Claims Preparation I: Clean Bills of Health Course Syllabus Page 9 Post your paper as an attachment.
CheckPoint: Features of Health Plans Resource: Table 1.1 on p. 13 of Medical Insurance: An Integrated Claims Process Approach Due Date: Day 3 [post to the Individual forum] Post a 250- to 300- word response to the following: Describe the similarities and differences among the major types of health plans. Do you believe any one plan offers greater financial or coverage benefits to either a consumer or a provider? Explain your answers.
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Discussion Question 1 Due Date: Day 2 [Main forum] Post your response to the following: Summarize the purposes and provisions of HIPAA in one sentence. Also explain how HIPAA relates to medical ethics and etiquette. What are some possible ramifications of a health care industry without HIPAA regulations? Refer to p. 25 of Medical Insurance and provide examples
Discussion Question 2 Due Date: Day 4 [Main forum] Post your response to the following: How do effective medical compliance plans limit the risk of professional liability? Do you believe it is reasonable to hold a provider liable for the actions of his or her clerical staff? Support your opinion with an example.
CheckPoint: Medical Records Documentation and Billing Due Date: Day 5 [Individual forum] Post a 250- to 300-word response to the following: Describe how compliance plans correlate to different medical records documentation standards. Which steps in the medical billing process studied in Ch. 1 of Medical Insurance are related to the following: o Compliance plans o Medical records o Documentation standards
Assignment: Understanding the Patient Intake Process Resource: Figure 3.1 on p. 75 of Medical Insurance Due Date: Day 7 [Individual forum] Write a 750- to 1,050-word essay discussing strategies to improve patient intake efficiency not covered in the text. Include the following components in your essay: o Provide at least one “must-have” item not covered in the text. o Provide a minimum of one reliable reference from the University Library or the Internet.
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Discussion Question 1 Due Date: Day 2 [Main forum] Post your response to the following: Suppose you were helping a new office file clerk who was curious about the coding process. How would you explain appropriate use and purposes of the Alphabetic Index and Tabular List to the file clerk? What problems can occur if proper coding procedures are not used? Provide examples of problems and propose solutions.
Discussion Question 2 Due Date: Day 4 [Main forum] Post your response to the following: What is the main distinction between V and E codes? How are they similar or different? What are your suggestions to streamline the V and E coding process? Explain your answers.
Discussion Question 2 Due Date: Day 4 [Main forum] Post your response to the following: Briefly explain the steps used to assign HCPCS codes for billing purposes. Also, do you believe it is more or less efficient to use different billing procedures for Medicare, Medicaid, and private payers? Why or why not? What are advantages and disadvantages of having unique coding systems for each type of insurance?
Assignment: Evaluating Compliance Strategies Due Date: Day 7 [Individual forum] Compose a 750- to 1,050-word essay evaluating billing and coding compliance strategies. In your essay, provide an overview of the compliance process, and offer your judgment either supporting or criticizing a particular method. Make suggestions for improvement at the end of your evaluation. Consider the following information in your essay: o What is the importance of correctly linking procedures...(more)
CheckPoint: Errors and Compliance in Coding Resources: Pp. 207 & 211 of Medical Insurance, NPR Web site, and Medical News Today Web site. Due Date: Day 5 [Individual forum] Review the NPR Web site at www.npr.org/... Post a 250- to 300-word response to the following: Briefly explain causes and solutions for three of the most common billing and coding errors. What effect does the Medicare National Correct Coding Initiative...(more)
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Discussion Question 1 Due Date: Day 2 [Main forum] Post your response to the following: How are the data elements contained in the HIPAA 837 claim form similar to the CMS-1500, and how does each form relate to the claims process? In your opinion, do the similarities between HIPAA 837 and CMS-1500 complicate or simplify the claims process? Explain your answers.
CheckPoint: Applying Level II HCPCS Modifiers Resource: Table 6.2 on p. 195 of Medical Insurance Due Date: Day 5 [Individual forum] Apply the appropriate Level II HCPCS code modifier for each of the following examples. Explain your rationale for each selection. a. Portable home oxygen unit b. Emergency ambulance transport and extended life support c. Diagnostic mammogram, left breast d. Cortisone 10 mg injection, right shoulder e. Non-electric wheelchair f. Intravenous...(more)
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CheckPoint: Eligibility, Payment, and Billing procedures Resource: pp. 86-88 of Medical Insurance Due Date: Day 4 [Individual forum] Post a 250- to 300-word response to the following: Describe a factor that determines patient benefits eligibility. What are the appropriate steps to take when insurance does not cover a planned service? Relate these steps to the eligibility factor you identified and provide two examples of patient charges with corresponding billing transactions.
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CheckPoint: Determining Diagnosis Code Categories Resource: pp. 130-135 of Medical Insurance Due Date: Day 5 [Individual forum] Post a response to the following: Determine a diagnosis code category for the following case studies and explain the rationale for your selections: o A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders... (more)
Assignment: Assigning Evaluation and Management (E/M) Codes Resources: Figure 5.3 on p. 161 and Table 5.4 on p. 165 of Medical Insurance Due Date: Day 7 [Individual forum] Assign appropriate E/M codes for the following five cases: o Initial consultation for a 78-year-old woman with unexplained weight loss, abdominal pain, and rectal bleeding. Comprehensive history and examination performed. o 30-year-old patient presents complaining of flu-like symptoms characterized... (more)