Reimbursement, Record Keeping, And Best Practices

that accepts Medicare assignments she will receive the walker for the Medicare approved cost. If

ReDiscover Common Ground is a community support services program that serves the residents of south Jackson County and north Cass County who live with severe and persistent mental illness. ReDiscover Common Ground is located at 6801 E. 117th Street in Kansas City, Missouri and transportation is provided for ReDiscover “members” (clients). Many of the residents being served at ReDiscover suffer from a dual diagnosis (DD) and therefore, addiction recovery services play a large role in the support for these clients. The clients also come from low socioeconomic statuses and often are reestablishing their lives after being released from jail or prison.

The recovery program is comprised of four phases. The first phase of the program referred to as SOS or “Safe off the Street” offers an environment for the client to become drug and alcohol free, commit to a plan of recovery and determine whether or not he wants to change. Clients move from the SOS phase into the Motivational Tracks where they focus on the first two steps of the twelve step program. During this phase clients are required to walk to classes that are held at off campus locations. This is referred to as “trudging” which shows their commitment to recovery mimicking the same commitment they had for their addiction. During this phase clients

My career that I am researching for my junior project is Medical Coding and Billing. Medical Coding and Billing are two different jobs. Medical Coding is when a patient has any medical procedure or exam such as going to the doctor for the stomach virus or even going to the hospital for a broken bone. They work with the insurance companies by putting a specific number into the computer. There’s CPT Codes which stands for Current Procedural Terminology which is “ Codes to better understand the services their doctor provided, to double check their bills or negotiate lower pricing for their healthcare services. (About Health, 2014).”

The price and cost list on the next page reflects the current selling prices and costs for Waren’s twelve products. Waren purchases all products for resale from one vendor, Super Electric Company. Waren sells each inventory item at the same price to all customers. A new price and cost list is prepared each time there is a change in an item’s cost or selling price.

As a Reimbursement Assistant, I made tons of phone calls to major insurance companies on behalf of the physicians’ network for inquiries on payment disputes. In the claims’ system I provided information, per the calls, for the Analysts to figure out the next steps to resolve the payment disputes. Other duties in the Reimbursement position included: filling out claim readjustments; updating excel spreadsheets; and checking claim status through insurance companies’ websites. In the role of Teacher Assistant (as a graduate student), I sent emails to students for class updates and setup time for tutoring sessions. The professor wanted students to have access to different journal articles. I scanned the articles into pdf files and made them available

The treatment centers are intended to achieve community and emotional support, behavioral, and educational needs of youth in rehabilitation. Youth enrollees must earn a successful release by completing spectrum seven stages of intellectual healing process aimed to changed delinquent thinking and behavior. The program is customized and time in treatment is uncertain for each enrollee. Normally, treatment last 12 to 14 months, though based on each youth treatment mission.

Hospital reimbursement: Outline the significant components that make up the CMS IPPS (inpatient prospective payment system).

A deposit may not be required if authorization is verified prior to services being rendered (n.d., Mayo Clinic). Other health insurance plans that may participate with Mayo Clinic may be disability insurance, motor vehicle insurance, prescription plan cards, and workers’ compensation. It is important to keep in mind that there are many commercial or traditional health insurance plans that Mayo Clinic might not participate with. It is best to check with your employer, health plan or other appropriate party about your health plan benefits before being seen (n.d., Mayo Clinic). Mayo Clinic offers an uninsured discount which provides financial assistance as well and will supplement the Mayo Clinic Charitable Care and Financial Assistance Policy. This discount will apply to medically necessary inpatient and outpatient services to residents of the United States after applying for Medicaid, Medicare or other Medical Assistant programs and denied. Being underinsured may include high deductible, high out-of-pocket maximum requirement, limited benefit plan(s), or no contracted insurance plan (n.d., Mayo Clinic).

Blue Ridge Mountain Recovery Center is known as one of the leading addiction treatment programs in the United States. The inpatient program at Blue Ridge lasts from 35 to 45 days in duration. The facility utilizes a holistic approach, combined with a 12-step program model, to structure counseling and therapeutic sessions. Program elements include educational speakers, 12-step meetings, group and individual therapy sessions, spirituality group meetings, relapse prevention education and training, recreational activities, and specific men’s and women’s groups. Blue Ridge Mountain also offers dual diagnosis treatment for those suffering from addiction and a co-occurring diagnosed mental

To meet these challenges Unlimited Second Chances has developed a comprehensive system navigation and linkage program in effort to increase access to needed public health, behavioral health, and/or social services. Working in collaboration with various community- based organizations, healthcare services, and local social services etc. Unlimited Second Chance will provide individuals formerly incarcerated with access to much needed resources in order to appropriately reintegrate back into their communities. However, although Suffolk, Franklin, Southhampton County and Isle of Wight offers a variety of programs that assist ex-offenders with reintegration many are simply inundated with the connecting process. Therefore, the comprehensive system

The passing of the Deficit Reduction Act of 2005 made an additional incentive possible for acute care hospitals who take part in the HCAHPS survey. Since July 2007, hospitals who are subject to the Inpatient Prospective Payment System (IPPS) annual payment update provisions need to collect and submit HCAHPS data if they want to collect their full IPPS annual payment. Inpatient Prospective Payment System hospitals that ignore to report the required quality measures, which includes the HCAHPS survey, could get an annual payment update that has a reduction of 2%. Hospitals like Critical Access Hospitals, can also participate in HCAHPS if they want to.

Since inception, TTC staff has worked tirelessly to expand the number of students enrolled and seen at TTC. For many of these students, financials barriers have prevented them from seeing medical providers on a regular basis. The Tiger Treatment Center accepts all types of insurance and provides various types of financial aid to remove these barriers and make health care accessible and affordable to anyone in need. The Tiger Treatment Center is a subsidized by NLHA to offset the losses experienced by the program. Without the continued contributions of NLHA, the Tiger Treatment Center could not continue to provide these services and many of our youth would lose access to the care that they desperately need.

The best way to handle a claim is to keep your cool and be patient. Staying patient sends a positive message that has a direct tone and clear explanation. Also, patience resoles any confusion about the claim. Keep in mind ones’ natural defense of confusion is anger. However, having patience and updating new information or explaining the problem clearly can help settle the

We are a South Carolina authorized supplier of Rehabilitative Behavioral Health Services (RHBS) helping kids, young people and families improve their lives through successful psychological wellness and substance misuse administrations. With two advantageous areas, we give individuals all through South Carolina with outpatient behavioral wellbeing administrations that emphasis on the individual – not the disease – and can help turn lives around. .