Hospital Billing Process Paper

Electronic Health Records will include the same information as the paper record. This includes basic patient information such as demographics, medical history, medications, allergies, laboratory results, radiology images, and billing information. (2006) Each individual doctor can specialize their system and what they want it to include. They can add different components to the electronic health record that are important to them and needed in their practice. (2006)

HIM Personnel play an important role in the Medicare system. Medicare has transitioned from “fee for service” to providing incentive payments for providers that issue high quality care at affordable prices. In order to achieve the “pay-for-quality” incentives hospitals and health care officials must improve their documentation processes. “If it isn’t documented, it wasn’t done” is more important than ever. It is the responsibility of the HIM professional to ensure the integrity of the patient chart. HIM professionals monitor the quality of documentation and ensure all clinical documentation is complete and accurate. HIM professionals are the key to identifying process problems while keeping in mind patient safety, quality of care, and revenue integrity. Medicare requires that hospitals report quality improvement measures in order to receive payments; HIM professionals can directly impact Medicare incentive payments. HIM professionals are directly involved with the Medicare Audit Improvement Act. The HIM professional collects health data that is subject to the audits; HIM professionals are the point of contact for responding to Medicare audit requests.

The careful documentation and subsequent billing process within the course of a patient’s care is an important piece within the healthcare system as a whole. Proper documentation in a patient’s chart relating to any service or procedure is not only important for this patient’s future medical care, but for the facility to receive an accurate reimbursement for the services provided. Reimbursement is affected by every department within the hospital. Healthcare is a business in the long run, and inaccuracies within the reimbursement process will affect the financial stability of the hospital. If a department is mismanaging reimbursement data it could result

As a biller or coder, if it is not documented, it didn't happen that needs to follow to be able to give an excellent service to every patients. Documentation is the key to have an appropriate health patients result including demographics, health issues, and billing. “Consistent and complete documentation in the medical record for every patient is an essential component of providing quality patient care. This documentation is required to record pertinent facts, observations and findings, and must meet certain compliance standards.” If not documented that is not necessary to give any further diagnosis

We operate a small privately owned clinic so our extra budget requirements are less than that of some larger facilities. To change the current procedure and protocol for assessing risk, we have created a budget to learn more about how we can help prevent and handle our geriatric populations fall risks and train the community as well as our staff. We have established a budget for continuing education for our nurse practitioner, who in turn will relay that training to our medical assistants and staff in our clinic. We have also created additional tools, and patient information forms and brochures, that will require additional funds to produce.

In the medical billing revenue cycle, there are ten steps. The first step is patient preregistration where a patient schedules a visit and their insurance is either verified or on file. The second step is to determine the patient’s payment when visiting the provider and the reason for their visit. Next is to check the patient in upon arrival at their visit. This is to verify the insurance and the identity of the patient. The patient is checked out after seeing the provider and charges for services will show on the superbill. After this, the medical biller takes the patient’s superbill and creates a claim. From here, the biller must ensure that the claim is compliant with coding and arrangement. From here, the claim is prepared and finally

responsibilities and duties in maintaining the records to meet needs of health care stakeholders. Abuse

Billing and Coding compliance strategies protect physicians from financial risk and potential loss of revenues. Physicians must document fully the service they provide and put in force a plan that prevent or reduce coding errors. According to, “The Journal of the National Medical Association,” there are 10 top billing concerns for physicians:

Medical coders, are always working side by side with medical billers and although many people confuse these professions as the same thing, medical coders and billers have different responsibilities individually. It’s a good idea to get your medical coding certification not only because most jobs now a days require some type of schooling, but its also a good idea because it shows the company that you are someone that could fit in just fine. Certifications also shows that you are proficient in your area and are committed to quality healthcare by disseminating quality information, it’s one of the first qualifications that employers look for when they review you as a potential candidate, and it’s an asset when you’re negotiating a salary. In addition, the majority of billing companies have contracts with their clients that obligate

A HIM professional is trained in the most up-to-date health information and technology, they are trained to work in any healthcare setting, are vital to daily operations, management of health information, and electronic health records. The job of a HIM professional is to ensure that patient records are accurately kept, complete, and private. Being a skilled HIM professional tells an employer that a person is organized and will have the right information on hand when and where it is needed while maintaining the highest standards of data integrity, confidentiality, and security. Becoming a HIM professional means that the professional is versatile and has the skill set to incorporate clinical, information technology, leadership, and management

Year in ago, I went to school for medical billing. My teacher advised what can and can’t be done to a claims form. This is Billing 101. I trying to locate this information before. I think it’s something that you have to go to school for. Nevertheless, I will continue to look for something that you can reference to the provider. The rule is the claims has to either be all handwritten or all types. It can’t be both. You can’t us white out on a claim.

This assignment will concentrate on medical billing, and compliance strategies, and the evaluation of these strategies. Many mistakes are made during the billing process, and some of the mistakes that are made could be caused by the strategies, and the processes themselves. In this essay I will offer a quick overview of the strategies, and an evaluation of these strategies. I will also offer my suggestions on how to fix the problems that were found in the evaluation. In this essay I will also attempt to answer these questions: What is the importance of correctly linking procedures and diagnoses? What are the implications of incorrect

Serves as a liaison for the Health Information Management (HIM) activities and sub-committees assigned to HIM.

The relationship between patient’s accounts, data flow, and charge capture is simple, it’s everything starting from when the patient walks in to a hospital all way up until they are discharged. First the patient will come in request services, and provide there demo-graphic. Insurance and medical information. All this information is collected for the hospitals different departments to provide correct patient care and treatment as well as charge the patient properly once treatment is completed.

The data flow of a patients account starts as soon as they report to a facility for any illness. This system is very important and there are many steps involved in order to maintain the patients’ data flow correctly. Any deviation from the data flow will interrupt this process and can cause many problems. It can have an impact on the patients care and disrupt the entire data flow all the way to the final billing process. As soon as a patient arrives for medical treatment their patient account is created; this starts the data flow cycle. In order to create a patients account a lot of information must be obtained, this includes their demographic information, insurance information and their medical information. Once this information is obtained and entered into the HIM system it allows all of the various departments’ to access the information that they need to make sure that the patient receives efficient treatment. Therefore, by setting up the patients account; the start of the data flow system begins and is updated every time the patient receives any form of medical care, testing, surgeries, and any other medical treatment. As the data flow is entered all information pertaining to the patient is captured within the HIM system; this is called charge capturing and this information will be used