"Overview of medical billing and coding compliance process" Essays and Research Papers

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    Coding Slogan

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    contains its own codes and has its own role in the medical billing. To help you determine which section you are going to use‚ I have made the following buzzwords for each section. Category I is the most important category of the CPT Process. We will use this section for all billing situations. Because this is the most important section we are going to consider it the heart of our billing world. Just like our bodies can’t function without our heart‚ a billing specialist can’t function without section 1

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    CPR is the abbreviation for cardiopulmonary resuscitation. CPR is a procedure used to keep the heart pumping and oxygen flowing until emergency care arrives (Tyler‚ 200). First Aid is where help is given to a sick or injured person until full medical treatment is available. First Aid and CPR is very important to the healthcare worker in so many ways and I plan to explain these reasons in my paper. First Aid and CPR are very important to know in the healthcare field. Nurses‚ doctors‚ and etc

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    Professional Organizations and Credentialing Examinations | The American Association Of Medical Assistants & TheAmerican Medical Billing Association Introduction Throughout the medical community there are a growing number of organizations whom offer certification exams for those looking to enter the medical assisting field or other allied health profession. Few of these organizations offer the high

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    | Evaluating Compliance Strategies | [Type the document subtitle] | | This is about the evaluating compliance strategies on billing and coding and how if following the guidelines of the insurance companies. Also that the payer will paid the bill if it is correct. | | By: Bonnie S. Jarosiewicz | 1/15/2012 | | 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

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    The compliance process is very important in medical billing and coding. After a patient is seen‚ physicians document the patient ’s visit. Medical administrators then post the medical codes of the visit in the practice management program (PMP) and prepare the claim. It is important to prepare claims correctly in order to stay in compliance. A correct claim connects a billed service to a diagnosis. The diagnosis has to relate to the billed service to treat the patient ’s ailment. The connection is

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    Coding Tips

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    describe the patient’s condition‚ using terminology that includes either specific diagnoses and/or symptoms‚ problems‚ or reasons for the encounter. In the instance where a discrepancy is discovered‚ determining the first-listed diagnosis per the coding conventions of ICD-9-CM‚ as well as the general and disease-specific guidelines within ICD-9-CM‚ will have precedence over the outpatient guidelines. •In the outpatient setting‚ code all documented conditions that coexist at the time of the encounter

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    Evaluating Compliance Strategies June 4‚ 2013 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

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    Evaluating Compliance Strategies HCR/220 January 3‚ 2011 Fonzette Mixon Evaluating Compliance Strategies The compliance process is set up to ensure the maximum appropriate reimbursement for health care claims. Correct billing and coding are directly linked to correct documentation by a physician. Also‚ to complete documentation‚ linking the correct code to the correct diagnoses is a must. This step is vitally important in reducing compliance errors. Second‚ the implications of incorrect

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    Billing Fraud

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    Medical Billing Fraud What is Medical Billing Fraud? It is an attempt to fraudulently obtain payments from insurance carriers. Medicare and Medicaid are the most susceptible to fraud because of their payment arrangements. Fraud in medical billing cost tax payers and medical providers millions of dollars annually. In 1996‚ HIPPA established the Health Care Fraud and Abuse Control Program (HCFAC) to help combat medical billing and health care fraud. Fraud is an act done with the knowledge that you

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    Why Is Coding Important?

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    Coding is the basis for revenue and reimbursement for healthcare facilities. When a health record is coded based on quality documentation‚ then that should allow for the maximum reimbursement by the third party payer to the facility. If the medical codes are entered correctly‚ the procedure or treatment is medically necessary‚ and preauthorized according to the insurance company then the claim should be approved. For example if a health record is coded for gram negative pneumonia and the documentation

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