Preview

Medical Administrative Assistasnt

Satisfactory Essays
Open Document
Open Document
370 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Medical Administrative Assistasnt
Chapter Highlights | Chapter Highlights Medical Insurance means many things to many people. To some, it is a mound of paperwork. To other's it is a mass of confusion and replication that seems to change constantly. For a patient with an illness or injury, health insurance helps defray the high cost associated with healthcare. | There are both paper, or hardcopy claims, and electronic forms that are used to file health care claims for reimbursement. | This week we will examine both types of claim forms, and learn to complete a CMS 1500 form. By the end of this chapter you will be able to explain how to gather information necessary to successfully complete a claim form. | Accurate completion of the CMS-1500 claim form begins with the gathering of the patient's and the insured's demographic and insurance information; the diagnoses and the procedures and services performed; and the provider's identifying information. | The patient registration form is used to collect the patient's and insured's information, and confirmation of all collected information is an important task that should not be neglected. | This can be done by photocopying the patient's and insured's insurance cards and driver's licenses; verifying eligibility and benefits; and, when applicable, securing approval from the insurance payer in advance for procedures, services, and referrals. | A wise medical assistant creates a checklist of all the information needed to complete an insurance claim correctly. | |
Ultimate Medical Academy - All Rights Reserved Chapter Highlights | Chapter 12 Highlights The Musculoskeletal System subsection classifies procedures performed on bones, cartilage, joints, ligaments, muscles, and tendons and includes casting and strapping. | The CPT Musculoskeletal System subsection is arranged from head to toe according to body area and includes the following headings: General, Head, Neck and Thorax, Back and Flank, Spine, Abdomen, Shoulder, Humerus and

You May Also Find These Documents Helpful

  • Good Essays

    5. Name and address of the payer. Make sure the patients name, address and phone number is on the check and correct.…

    • 602 Words
    • 2 Pages
    Good Essays
  • Good Essays

    The person submitting forms to the insurance company may have put information incorrectly onto the document. This can create a problem with insurance companies and in turn can cause more problems. It is important for a medical professional to be careful and diligent as it will not only save time for the physician but also for his office. Not to mention, the patient will be…

    • 364 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    When a payer receives a medical claim, it goes through a five step process called adjudication where it is inspected and reviewed for processing, evaluation, or modifications if necessary.…

    • 364 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Working in the medical billing industry can be daunting at times. My last position as a follow up representative, proved to be the most challenging job that I have ever had. I have an extensive background in the medical insurance industry. I was aware of the way that claims were to be handled and submitted to insurance companies. The company that I had worked for had just won a contract for taking over the medical billing for twelve physicians in Portland, Oregon. Right off the bat, there were a variety of issues concerning how to bill the medical claims correctly. Claims have to be submitted on time, with the correct codes and information on them, before they can be processed by the insurance company.…

    • 370 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Hca/230 Working with Teams

    • 1113 Words
    • 5 Pages

    The first person to question would be the front office personal who checks in a patient upon arrival. After getting the insurance card and demographic page, it is important to compare that information on file to be certain it is accurate, and up to date. A copy of the insurance card should be taken at every visit. Even if the patient were there just there a few weeks ago, it is important to establish a routine of quality. Second, the front office personal should check the insurance carrier to see if a referral is necessary. However, most insurance carriers do not require a referral for family practice it is advantageous to determine if the doctor is in network.…

    • 1113 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    Hit-150-Wk4D1

    • 539 Words
    • 3 Pages

    3. The Carrier-direct electronic claims submission method allows the provider to communicate directly with the insurance company.…

    • 539 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    Because this is an important step, many facilities use a professional to prepare the claims and send them out. A claim contains a patient’s diagnosis, treatment, and charges to the coverage company. These claims need to be extremely accurate and filed on time. Monitoring the payer adjudication is step eight, it helps the coverage companies decide if they should pay the full claim, part of the claim, hold off until further information is obtained, or denied completely. After the decision is made, a letter is sent back to the facility and a specialist makes sure that all the payments are accounted for and the reasons for denial are given. Many times the coverage company does not pay the full amount and here is where step nine comes in. What the company will pay is deducted from the patient’s bill and the final bill is given to or sent out to the patient to pay their…

    • 749 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    Medical records should follow a compliance plan to insure all areas of patient records are complete. Medical records apply to all steps of the billing process. These areas include record accuracy, patient’s condition and diagnoses, the patient’s course of care should be outlined. Medical records must be accurately completed and kept up to date with the patient’s current information. Patient records are private legal documents and in order to avoid any legal actions the compliance plan should be followed.…

    • 271 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    design a finanial policy

    • 568 Words
    • 3 Pages

    The medical office needs to ensure that each patient is aware of their billing policies and…

    • 568 Words
    • 3 Pages
    Good Essays
  • Good Essays

    There are times that the claims are not complete and are return to the medical office for further information. Because a lot of claims have been sent back to the medical office they have to come back with a decision that is evaluating compliance strategies in medical coding to keep the billing consisting and efficient.…

    • 804 Words
    • 4 Pages
    Good Essays
  • Satisfactory Essays

    Cindy Smith

    • 469 Words
    • 2 Pages

    Duties: Received inbound calls from doctor offices and medical billing and coding representatives regarding processed and unprocessed medical claims status .Also handled calls…

    • 469 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    1. When the patient is contacted, you must identify yourself, the practice, and the purpose of the call. When you are speaking to the patient, you must verify that the patient has received a copy of the bill. You must also inform the patient of the status of their account and what needs to be accomplished.…

    • 390 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    Many factors determine a patient 's eligibility for benefits. Employment status is one factor that may determine whether or not the patient still has benefits. If an employee no longer has a job they are by law to be offered what is known as COBRA by their employer for up to one year of termination or a new job whichever comes first.…

    • 399 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Many facilities and physician offices maintain patient records in a paper format known as a manual record. A variety of formats are used to maintain manual records, including the source oriented records (SOR), problem oriented records (POR), and integrated records.…

    • 707 Words
    • 3 Pages
    Good Essays
  • Good Essays

    CLAIMS ARE PROCESSED THROUGH THE PAYER'S AUTOMATED MEDICAL EDITS: Once claim is received it has to go through a comprehensive review that is performed by a computer software program that is designed to find errors or discrepancies on the claim form by scanning each claim to make sure information is correct and all necessary information is present on the claim and it conforms to the insurer's policies. This is called editing and any errors found can cause the healthcare provider not to be reimbursed by the insurer.…

    • 532 Words
    • 2 Pages
    Good Essays