Reimbursment2-1
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Purdue University *
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203
Subject
Health Science
Date
Feb 20, 2024
Type
docx
Pages
4
Uploaded by ericaharmon33
Erica Harmon Catina Flagg
Healthcare Reimbursement
SNHU (Southern New Hampshire University)
11/05/2023
The daily responsibilities of the physician and billing staff are significantly impacted by medical billing and coding rules. Because the laws and codes have changed so drastically over the years, it is critical that billing departments and doctors keep up to date on advanced training and understanding of both current and upcoming changes to the codes.
Changes in rules may also result in claim denials due to improper procedures or coding. Due to this, the operations of some smaller providers have had to stop altogether, and others have even had to shut. For the billing to be done precisely, the entire cycle must be completed correctly from the start.
To reduce the possibility of billing errors, it is essential to have a staff that is trained in the latest legislation. Medical claim billing and coding standards are complicated, and it can be challenging to remain on top of them. However, doing so can help avoid issues like fraud and abuse, improper claim payment, and potential readmissions to the hospital (AAPC, 2015).
The revenue cycle has seven steps: preregistration, registration, charge capture, claim filing, remittance processing, follow-up with insurance, and patient collections. This procedure ensures that timely payment to the provider office is made. Every office department has a procedure to follow, and they are all responsible for following. Every piece of patient data is acquired and input into the system during the preregistration phase.
Every receptionist who answers phones and gathers patient data falls under this category, as will the front desk. In this procedure, this is the most crucial stage. The registration phase is the second in the procedure. Staff members are responsible for verifying and fixing any errors in the patient's preregistration data at this phase. Also, authorization status confirmation is done now. If
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