Preview

How Does HIPAA Influence The Medical Billing Process?

Satisfactory Essays
Open Document
Open Document
366 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
How Does HIPAA Influence The Medical Billing Process?
Capstone CheckPoint
Week 9
Megan Batson

When it comes to HIPAA, ICD, CPT, and HCPCS on how they influence each of the ten steps of the medical billing process, HIPAA influences the billing process by maintaining HIPAA compliance, as far as confidentiality and the handling of the medical record. When it comes to ICD, CPT, and HCPCS they influence the billing process they are the reference source where the codes are contained that are used to find the diagnosis, procedure, and the supply codes. But the HIPAA, ICD, CPT, and HCPCS they are all some kind of way related to have something to do with the billing process, but the ten steps during the process are 1. Preregistration 2. Establishment of financial responsibility 3. Checking

You May Also Find These Documents Helpful

  • Good Essays

    We have gone over our books and looked at our labor growth over the last 6-7 years. Here is a summary of our situation. All numbers are based on billed services only. Costs of goods sold are NOT included in any of the numbers. Our average growth per year over the last 6-7 years is 48.62%. If we take out our best and worst years for growth then our average is 31.62% each year. We are currently on pace to easily hit $126,703.79 in labor for 2016. Our labor increased by 34.84% from 2015 to 2016. We just added two managed service clients this month. Now we have 20 managed services clients that add up to $120,720.96 per year. As you know this is the most valuable part of our business.…

    • 699 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    1- How could his physician’s office have prevented this problem? I think that the physician with it avoid this situation if they have Communication this is the most important point for a successful resolution of this kind of problem .…

    • 112 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    In my own words how, HIPPA, ICD, CPT, and HCPCS influence each of the ten steps of the medical billing process is that when it comes to medical billing and the coding process, there is a special task that must be completed by the billing staff members of any medical facility, whether it is a small doctor’s office or a large hospital. They must provide quality care in the mean while protecting the patients’ privacy and expediting the payment of services rendered. There are ten steps to this process: pre-registration, establish the financial responsibility, the checking in and checking out of patients’, reviewing the coding compliance, checking the billing compliance, preparing and transmitting the claims, monitor payer adjudication, creating patient statements and the handling of collections. HIPPA policies are carefully reviewed by the patient’s informing them of the process necessary in transmitting their claims and the facilities devotion to their confidentiality.…

    • 264 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Workplace Application: Provides student with basic knowledge about HIPAA compliance as they apply them within the medical office environment.…

    • 351 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    With this definition in mind, the proficient application of EMTALA and HIPAA to our scenario and discussion of the rights, duties, and responsibilities of patients and providers can transpire.…

    • 709 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    In step four; checking out the patient, along with applying and entering proper codes (Valerius et al., 2008); you are complying with federal regulations for coding and billing. In step five; the process of reviewing coding compliance (Valerius et al., 2008), you are, again, satisfying official requirements. When checking billing compliance in step six; you are assuring the proper charges have been billed and correcting any errors (Valerius et al., 2008). This reduces the risk of liability to the practice for improper billing or fraud, thereby maintaining a proper compliance plan within the practice (Valerius et al., 2008).…

    • 565 Words
    • 3 Pages
    Satisfactory Essays
  • Better Essays

    The receptionist or other clerical worker will either call, or receive a call from a “patient” or other authorized individual. During this communication, the associate must be careful to observe HIPAA rules related to “protected health information.” when “schedule, canceling, or rescheduling” encounters. When gathering benefit “information,” the representative must be diligent to accurately enter data into the “patient’s” file. Discerning insurance cards, policies, and all applicable guidelines of each plan are applicable to the “front and back” office. Abiding by the payer’s regulations, and the coordination of benefits,” associates will input this data into the patient management program (PMP). During these procedures, insurance specialists will be cautious to correlate the correct information with the correct patient. The “front or back office” will then confirm coverage with designated plans, along with all essentials, such as if a “referral or preauthorization” is a requisite. Prior to consulting with the physician, patients will need to be alerted about their rights, in coordination with HIPAA privacy standards, as well as those of the provider. During that time, if the patient owes any monies for coinsurance, or copayments, this will be submitted to the “front office.” While checking out patients, insurance specialists will transfer the descriptions of “diagnoses and procedures” from the “physician’s report” into appropriate “codes” for ‘claim” generation. This facet is most crucial, because of the HIPAA specifications regarding the transfer of PHI “by covered entities” (Valerius et al., p.…

    • 1235 Words
    • 5 Pages
    Better Essays
  • Satisfactory Essays

    * This is a very important step because it involves the determining of who is financially responsible for the visit. It also is used to establish what services may be covered under the type of insurance they have, along with payment options plan options if any, and what types may be available to the patient.…

    • 672 Words
    • 3 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Capstone Individual

    • 338 Words
    • 2 Pages

    The medical billing process consists of ten steps that can be categorized into three main groups that break down how the Health Insurance Portability and Accountability Act (HIPAA), International Classification of Diseases (ICD), CPT, and HCPCS influence each of the ten steps. The main groups are: pre-registrations, claims preparation process, and finalizing the claims processes.…

    • 338 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Medical Billing

    • 363 Words
    • 2 Pages

    Silvestri: Companion CD-ROM for Saunders Comprehensive Review of Nursing for the NCLEX-PN® Examination, 4th edition…

    • 363 Words
    • 2 Pages
    Satisfactory Essays
  • Better Essays

    Also there are state laws that may put more restrictions on your health care information. In the future there will be more training as new laws and rules are established.…

    • 642 Words
    • 3 Pages
    Better Essays
  • Good Essays

    retrieve your records by filling out a form, and you are allowed access to your…

    • 548 Words
    • 3 Pages
    Good Essays
  • Good Essays

    HIPPA Violations need to be taken very seriously in the healthcare field. I am sure most employees are not aware of the penalties involved with a HIPPA violation. The American Recovery Act of 2009 created a tiered penalty for HIPPA violations. But it is the Office of Civil Rights that determines the amount of each penalty, and is dependent upon the nature and extent of harm that results from the breach (CMS, 2013).…

    • 320 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    Hipaa

    • 501 Words
    • 3 Pages

    HIPAA came into place “to improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, included Administrative Simplification provisions that required HHS to adopt national standards for electronic health care transactions and code sets, unique health identifiers, and security.” (U.S. Department of Health & Human Services) Then after getting all the policy and procedures into place it became effective in February of 2003. The HIPAA policies help to protect all parties in the medical field including the patients and physicians.…

    • 501 Words
    • 3 Pages
    Satisfactory Essays
  • Powerful Essays

    Healthcare Reimbursement

    • 2290 Words
    • 10 Pages

    To understand how fraud impacts coding systems one must understand how medical professionals and health care facilities are reimbursed for their services. In most cases a patient does not pay for a service directly. Most payments to medical professionals and health care facilities are made by a third party payer, whether it is private insurance or a government program like Medicare. “The ICD-9-CM is used by physician’s offices to code and classify morbidity data from medical records, physician offices, and surveys conducted by the National Center for Health Statistics” (Valerius, Bayes, Newby, Seggern, 2012, p. 128). This is the coding process. They billing or coding specialist fills out the coding form to send to the third-party payer (insurance company) so the hospital or physician’s office can be reimbursed for the services rendered.…

    • 2290 Words
    • 10 Pages
    Powerful Essays