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Reimbursement Methodologies

CREATE A TRAINING GUIDE Health insurance, appeals, and reimbursement, you can complete the following project. Goal The goal of this project is to apply the following Scenario You’ve recently been hired as the manager of a Billing and Coding Department in a large physician practice. As the Billing and Coding Manager, you’ll be responsible for training new employees. For this project, you’ll develop a training document in Microsoft Word. Be sure to discuss the following within your training document: 1. How does incorrect patient information impact a claim? 2. What is correct coding? What is meant by a clean claim? a. Discuss coding of Evaluation and Management Visits. How must medical documentation support provider billing? b. Discuss use of correct diagnosis codes. 3.Discuss HIPAA and electronic filing. 4. What is meant by federal compliance? 5. What is workers’ compensation? a. Discuss the types of workers’ compensation. b. Discuss the role of the ombudsman. 6. What is the Center for Medicare Physician fee schedule? a. Discuss what is meant by 80/20 reimbursement. b. Give an example of an office fee and how you would bill 80/20. 7. When a claim is denied, what is the process for filing an appeal? 8. What is meant by timely filing? 9. What is a recovery audit contractor? Discuss how this can impact a physician practice. 10. Bring your training to a close by summarizing what you’ve covered. 11. Discuss the path of a claim from the time the front desk receptionist receives the superbill when the patient checks out to the final receipt of payment **Type your submission, double-spaced, in a standard print font, size 12. Use a standard document format with one-inch margins.**

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