Medicare
We have talked a lot about Medicare during this course because not only is it the largest single health care program in the U.S., but it often sets the standard of practice for other insurance groups. Using this video, review some of the features of Medicare and how Medicare has influenced health care in general. […]
Reimbursement Methodologies
A clean claim is a submitted claim without any errors or other issues, including incomplete documentation that delays timely payment. There are several required elements for a clean claim, and medical bills are denied if elements are incomplete, illegible, or inaccurate. A clean claim meets all the following requirements: · Identifies the health professional, health […]
National Correct Coding Initiative (NCCI)
The National Correct Coding Initiative (NCCI) was developed by the Centers for Medicare and Medicaid Services (CMS) to eliminate improper CPT coding, detect inappropriate CPT codes on claims and deny payment for them. NCCI edits are released 4 times a year. Significant to NCCI is the term “Mutually Exclusive.” Mutually exclusive procedures are those procedures […]
Using Medical Terms, Abbreviations, and Acronyms on the Job
As we have determined, there are many terms, abbreviations, and acronyms that health care professionals need to know and understand as part of their job responsibilities. It is important for you to familiarize yourself with the most common terms that a medical coder and billing specialist would be exposed to. Using Medical Terms, Abbreviations and […]
Practicum Focus Sheet Assessment 3
Expect to spend at least 2 hours with the patient, family, or group you’ll be working with during this portion of your practicum, exploring issues of technology, care coordination, and community resources associated with the health problem you’ve defined. This includes time spent in consultation with subject matter or industry experts. For this portion of […]