Medical billing and coding is a lot more detailed and difficult that many people outside of the medical field know. Because there are so many different codes and the numbers of different insurance companies, Medicare and Medicaid all have different codes among themselves it can become overwhelming for the billing staff in offices to make sure that everything is right. Unfortunately all the codes have to be correct in order for doctors and hospitals to get paid in a timely manner. All medical billing is started the same way though.…
It is a very long process for billing to prepare the bill that is required to submit for payment. There also have been a lot of mistakes when billing because some did not know the guidelines of medical coding when sending the bill to the insurance company. This assignment will show how to making medical billing and compliance strategies so mistakes will not be made. Even through that not any means is any one perfect…
On 1/9/2016, CM did a visual to locate the client to Bi-Weekly ILP Review and Hospital discharged follow up. Client was located in the Cafeteria. In the meeting client appears to be cooperative and friendly. Client speaks with a heavy Russian accent making difficulty to understand. She appears to be in no acute distress.…
Care should be taken at all times when administrating medication as it could be given to the wrong person which could lead to them suffering, or something as simple as the wrong dose. This type of mistake can have a devastating result for example in 2005 2 nurses miscalculated the dose of a drug needed to slow down a baby boys heart rate. He was given 10x the dose and he died.…
The compliance process is critical when it pertains to the billing and coding process. It is imperative for Medical Insurance Specialist to remain current on the patient’s participation in contract as well as the medical insurance policies, so there will not be any billing errors. Maintaining a communication with the payer will also prevent billing errors. Such regulations and laws are in place for to protect the patient’s financial state, prevent errors of billing and coding, and to link procedures and diagnoses correctly. Becoming knowledgeable of the billing rules should also help prevent billing errors as well. In this assignment, I will discuss how important it is for medical staff to be knowledgeable of the billing and coding compliance strategies.…
In 1999, the Institute of Medicine (IOM) released a report, "To Err is Human: Building a Safer Health System," in which, according to the report, between 44,000 and 98,000 deaths may result each year from medical errors in hospitals alone. And more than 7,000 deaths that occurred each year were related to medications. In response to the IOM's report, all parts of the U.S. health system put error reduction strategies into high gear by re-evaluating and strengthening checks and balances to prevent errors. In 2001, U.S. Department of Health and Human Services (HHS) announced a Patient Safety Task Force to coordinate a joint effort to improve data collection on patient safety. The lead agencies are the FDA, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and the…
and providers do not want harm to come to the patient, fortunately there are solutions that can help prevent this from happening. Organizations that are trying to achieve The Joint Commission’s 2017 National Patient Safety Goal of identifying patient’s correctly…
Mayo, H. B. (2012). Basic finance: An introduction to financial institutions, investments, and management (10th ed.). Mason, OH: South-Western.…
Upcoding by billing service companies on behalf of the physician. When filing claims appropriate codes on all levels of service provided must be documented. To avoid any fraudulent activities, a plan must be implemented that created sufficient and effecting guidelines which would ensure coding is within federal, state, and local laws. Not applying the appropriate code can go unrecognized, that is why updating and ensuring coding standards are current is such an important part of the coding process. Physicians that choose regularly to use higher level codes, when a lower level is required is participants of upcoding. OIG and other agencies will investigate and determine if such fraudulent activity has occurred and possible reprimands will be enforced, including jail time.…
Errors made while administering medications are one of the most common patient safety, health care errors reported. It is estimated that 7,000 hospitals deaths yearly are attributed to medication administration errors, and each error can cost a health care organization over $8000 per occurrence. (Anderson & Townsend, 2015. p.18). Nurses spend a significant amount of time managing, preparing, and administering medications. Nurses can spend up to forty percent of their day, involved in tasks that center around medication administration (Bourbonnais & Caswell, 2014). Over the past few years, there has been an incredible amount of new technology introduced in health care that affect medication administration. Electronic health records, computerized order entry, smart pumps, and bar-code medication charting all add complexity to the task of medication administration. Bar-code medication administration (BCMA) is one safety measure that can be implemented that can reduce medication administration safety errors and adverse…
Medication errors and adverse drug events vary from 5.1 to 87.5 incidents per 1000 patient days in ICUs (Wilmer et al, 2010). Computerised Physician Order Entry (CPOE) was introduced to minimise these errors and promote patient safety within the ICU setting (Kaushal et al, 2003; Rothschild, 2004). The SR and NR that the author has chosen highlight the importance of CPOE systems in promoting patient safety and reducing avoidable harm. The papers can be accessed using these references: Kaushal R, Shojania KG and Bates W (2003) ‘Effects of computerised physician order entry and clinical decision support systems on medication safety: a systematic review’ Archives of Internal Medicine 163 pp.1409-1416 and Rothschild J (2004) ‘Computerized physician order entry in the critical…
The use of two patient identifiers to verify that the correct medicine and/or treatment is being given to the correct patient is the first National Patient Safety Goal of 2016. In an acute care setting, nurses implement this during medication administration by scanning patient identification bracelets and confirming the patient’s name and date of birth verbally.…
On January 20th Dr. Mike Groves spoke to our class about healthcare. This is vital information, because since we are in the MBA program we will need to be knowledge on the inner workings of the healthcare system. It is even more important with the developments of the Affordable Care Act and how it impacts business today.…
Multiple failed organizational and departmental processes may lead to wrong patient, wrong procedure, wrong side or wrong site. Prevention of these errors requires a safety system to ensure accurate scheduling and procedure ordering. Proper patient identification will also eliminate these errors. Ensuring correct patient identification is a recognized healthcare challenge and the acute care poses the biggest challenge with this because of the wide range of care given, the locations it is given in and the numerous staff who work in shifts. Failure to correctly identify patients and correlate their clinical information to an intended procedure or study can be very harmful. Causes of wrong events with regards to patient care are:…
Drug shortages have become a hardship for hospitals and pharmacies across the country. This hardship has been felt especially by nursing personnel who have voiced their concerns regarding patient safety and medication management. “One factor contributing to patient safety concerns arises when a substitute drug must be used in place of the customary product and requires dosage strength or dosage form - the need for those adjustments may heighten the risk for errors”. (Alspash, February 2012) The American Hospital Association has been surveying hospitals across the country to try and gather what other issues health care providers are…