Home Medical Billing Essay

Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations

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.

occurred on Sunday. She states she was seen by the “eye doctor earlier today” and

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this

According to the US Bureau of Labor Statistics, the Medical Coding and Billing field is growing faster than any other field (Medical Billing & Coding Careers). The reason for this is that the more doctors’ offices open up, the more the need for medical billers and coders. As of today there are over 8000 codes being used to describe every procedure you can imagine (Sloviter, Sept-Oct 2009). Now think about being a doctor. It would be really hard for a doctor take care of his/her patients and keep track of all those codes. The field of medical coders and billers has a pay range of $8 to $10 per hour to start. However, that is also based on experience. The more experience, the more the pay. Considering that being the pay for full-time, plus any benefits such as vacation, health packages, and retirement packages – it may not seem like

Medical billing translates a healthcare service into a billing claim. The medical biller makes appointments, transactions, and follows the claim to ensure the practice receives.

Discuss the general differences between facility and non-facility rates. Discuss the MS-DRG system for hospital inpatient services. Include in your discussion the history of the MS-DRG system and the need for the updated system. There are two types of bills used in healthcare. Which type of bill is used for physician services? Which type of bill is used for hospital services? (Hint: your book is incorrect.)

For example an x-ray machine could be leased and the organization would a fee depending on how many x-rays they take per month or year.

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.

Great post, there are so many important things that come along with learning medical billing and coding. I'm getting a little overwhelmed because there is so much material to cover. When I first started reading about the different coding edits and how to use them I was very confused because it mentioned that every code does not have a MUE or CCI edit. I did find a full list of edits on the CMS website so that could be helpful as well. Since CMS updates the national correct coding policy each January we have to be aware of the changes. The more practice that we get the better we'll understand them. As I was doing my research there were several websites that you could go to that will explain the code edits.This discussion was definitely a challenge

There are advantages and ways that a single physician medical practice can start a card payment system. According to the research firm Javelin Strategy and Research; by the year 2017, twenty-three percent of all point of sale or counter sales will be made in cash ( Brooks, 2014). What this means is that over seventy percent of counter sales or point of sale transactions will be made electronically. It is, for this reason, prudent for all forms of business to ensure that they can evolve with the market. If the business is unable to do so, it is likely to lose its edge over its competitors. The Payment Card Industry Data Security Standard, regulates the way businesses or organisations handle credit card information or data.

* Re-Evaluate my 1st 30 days in the territory and adjust forward goals, objectives and action plan to insure goal attainment and production in the coming months.

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

Identify a government policy decision that has influenced or will influence your field of study.  The policy decision can be a federal or state agency rulemaking, legislative action, or court decision that has already been or will be implemented.  Discuss one positive and one negative effect that this policy has had or will have on your field.

The demand for medical care is derived from our demand for good health. Michael Grossman was the first to do econometric research on this topic. “Grossman’s work established two approaches for consideration. In the first, medical care is viewed as an input in the production function for health, and in the second, as an output produced by medical care providers (Henderson, p.142).” There are two main factors that determine the demand for medical care. The first is the patient factor. This includes a patient’s health status, demographic characteristics and economic status. The second is the physician factor. This is an interesting topic because it introduces the principal (patient)-agent (physician) problem. We are