For-Profit Health Insurance Companies
Most commercial insurance providers are for-profit companies. Policyholders’ monthly premiums fund commercial policies. Their premiums and coverage...
Rising Costs of Healthcare
During Week 2, our class discussion focused on the idea of "Medicare for All." Now that we have studied commercial versus government health...
Health Insurance Calculations – Medicare Non-Participating Provider
This scenario is for a non-participating provider who contracts with Medicare. Prior to determining the limiting charge, you must first decrease the...
Health Insurance Calculations – Medicare Non-Participating Provider
This scenario is for a non-participating provider who contracts with Medicare. Prior to determining the limiting charge, you must first decrease the...
Consider Frank Serpico, New York City Police Detective (Retired).
In the 1970’s, Detective Serpico “broke the ranks" and exposed police corruption in the New York City Police Department. As a result, he was shot in...
Effectively Using the Electronic Remittance Advice
The remittance advice is a key document that reimbursement specialists use daily on the job. This document, whether in an electronic or paper form,...
Dissecting the CMS 1500 Claim Form
There are many important details that are entered on a CMS 1500 claim form for a patient’s services that were rendered by a provider. Information...
Assign the appropriate CPT E & M level, procedures and ICD-10-CM code(s) for the physician office encounter
Assign the appropriate CPT E & M level, procedures and ICD-10-CM code(s) for the physician office encounter. When there are multiple CPT codes,...
What kinds of health care professionals work at your selected facility?
The purpose of this assignment is to evaluate different aspects of team development and collaboration within a health care environment, and to...
Research the literature on your selected health care problem
To prepare for your assessment, you will research the literature on your selected health care problem. You will describe the priorities that a care...