Billing Specialist Case Study

Diabetes substantially limits the life function of eating, and it also negatively impacts the life function of learning. Support to manage diabetes and a schedule to check blood sugar levels during non-instructional times of the day or the opportunity to make up any work missed during blood sugar checks are accommodations that would be in this student’s 504 plan. The 504 plan might also require all staff to be trained to recognize and handle any complications related to diabetes to ensure the child’s

Medical billing and coding specialists usually work in office settings. A computer, a telephone and appropriate documents are all used on a daily basis. Unlike other medical professions, there is little contact with patients. Medical coders work closely with healthcare providers and insurance carriers to gather and provide accurate billing information, but most communication take place in the form of phone conversations and mailings.

The goal is to increase the percentage of understanding of diabetes and how to live empowered with diabetes. I will conduct outreach programs in various methods to reach the people to participate in the health program. My objective is done by specific, measurable, achievable, results-focused, and time-bound (SMART) goals. By May 31, 2018, an increase of 40% establishes one-on-one follow up education session with each individual and families through home visits or phone calls to monitor them to improve their lifestyles. By February 30, 2018, an increase of 80% distribution of brochures and with door to door interactions with the individuals in the community. By September 2018, increase 90% of people to engage in community health fair, classes, and exercise activities on diabetes and cardiovascular classes. This will introduce the individuals in social support that allow interactions with teaching and

It is believed that NPs can overcome challenges with billing and coding, as well as Medicaid and Medicare, third party payers, commercial managed care companies’ reimbursements through appropriate coaching and remaining up to date on regulations. As mentioned earlier, implementing compliant electronic systems, staying well-informed of billing regulations, evaluating weekly reports, and consulting with compliance experts can aid in accurate reimbursement for NPs in primary care.

Other responsibilities would include the proper handling of requests for medical records. The person taking on this duty would also be responsible for administrating the training and assuring compliance of everyone in the organization.

For Medical Billers they will submit and follow up on any claims in order to receive payment for services from the patient or any health care provider. Both Medical billing and coding workers are the health care professionals in charge of processing patient’s data such as treatment records and related insurance information. Medical billers are in charge of making sure everyone is being billed correctly. Medical Billers interact with insurance companies just as much as Medical Coders. A normal day for a medical biller is day to day operations; prepare all billing for Medicare, Medicate, and all commercial insurance companies. Create electronic files, monitor payments and denials. When creating electric files, when a new customer is sent to you Medical office you will create an electronic folder just for them so everyone’s separate

Our Surgery Coordinator will take care of all our patients' insurance issues prior to surgery to make the stress of the financial issues less for our patient before entering surgery. He or she will speak directly to the patient about his or her scheduled surgery and pre-op instructions.

A person from the billing department who will run a report from the last 120 days. The doctor also needs a friendly reminder, to document according to the procedure. The doctor must know that treating patients is not their sole responsibility in an office.

Medical billing specialist are responsible for making sure the medical office and all the transactions, the diagnoses and procedure codes are taken from medical record documentation. Medical billers often communicate with physicians and other healthcare specialists to clarify diagnoses or to obtain additional information.

Hire one or two experienced medical billing and coding specialists to handle claims. They can do the work and keep it in-house. The practice gets compensated and all is good.

Type 2 diabetes is a chronic disease where patient education is imperative and requires education that surpasses the primary care office. According to Cha et al. (2012) basic education and family involvement is an essential component for pre-diabetic and diabetic population to achieve glycemic control. Time management and time constraint are obstacles that are affecting the primary care provider in initiating health promotion topics and disease prevention information (Kowinsky, Greenhouse, Zombek, Rader & Reidy, 2009). Recognizing the time constraint at the EBP change project site for health promotion and patient education a culturally sensitive educational program would be created to promote healthy lifestyle behaviors targeting African Americans with prediabetes.

My teaching on primary prevention of type II diabetes adheres to HP2020 objectives D-1 to D-16 on diabetes, specifically objective D-1 that deals with reducing the annual number of new cases of diagnosed diabetes in the population. (Target is a 10% improvement from the baseline of 8.0 new cases of diabetes per 1,000 population aged 18 to 84 years occurred in the past 12 months to the target of 7.2 new cases per 1,000 population aged 18 to 84 years). Education on the preventive measures needed to be taken by an at-risk population tackles this issue of reducing the annual number of cases.

First of all, medical billing is a process of submitting claims to insurance companies in order for health care provider to receive payment for service. Medical biller is the person that deals with claims. There are two different

Before you begin your teaching plan be sure to define the characteristics of the clinical site and patient population. The teaching plan should be customized to this population. This is a sample teaching plan that you can use and customize to your needs. You may want to design a pre-test and post-test to give your patients would are attending the teaching program.

The role of the Medical Insurance Specialist is very important to the financial operation of a doctor practice, hospital or other medical facility. A Medical Insurance Specialist collects all the information necessary to prepare insurance claims, enter patient demographics and insurance information, enter ICD codes and CPT billing codes, research, correct and resubmit rejected and denied claims, bill patients and answer patient questions regarding charges. The billing process is actually the process of communication between the insurance specialist, medical provider, patient and the insurance company. This is considered the billing cycle. The billing cycle could takes days to complete or it could take months.