You are a new graduate, and you just started work at a medium-sized hospital with an attached clinic. You have been asked to review the five different types of health care insurance plans and the characteristics of each to make sure the central business office (CBO) is up-to-date on all the rules and regulations. It is important to be familiar with these plans and the characteristics of each because they play a vital role in the reimbursement process for your health care organization. Discuss the following:
Five different types of health care plans:
- Medicare
- Medicaid
- TRICARE
- Worker's compensation
- Commercial insurance
- Differences in Plans
Each plan provides different coverage for various populations and has distinct instructions for submitting information on the CMS-1500 or CMS-1450. If the facility does not stay up-to-date on each plan and their reimbursement, they may not receive the correct payment for their services.