How health care entities bill for insurance


Assignment:

Here is what the assignment states:

Select a coder/biller for a health care provider or facility and conduct an interview to review the process the coder/biller uses to satisfy reimbursement requirements for billing purposes.

If you cannot find a coder/biller to interview, I am happy with you outlining the work for coding and billing based on the reading material and research.

Write paper (750 to 1,000 words) that describes the processes used in producing a final bill. Answer the following questions in your discussion:

1. How are health care charging and pricing processes different from other industries?

2. Explain the processes very clearly from the time the patient accesses services, which is usually at the time of making an appointment or registering for a service and payer information is collected. You will want to explain how coding works and why this is instrumental in the billing processes. Explain the billing component of the patient revenue cycle and how this works for the health care entity.

3. How do private and government insurers and payers impact actual reimbursement?

4. You will want to speak to how health care entities bill for insurance and what the differences are for Medicare, Medicaid and private insurance, addressing deductibles and copays, as well as self-pay.

5. Prepare this assignment according to the guidelines found in the GCU Style Guide, located in the Student Success Center.

Do not use the personal we, our, us, I and my in your writing. Use APA formatting for citations and references and make sure you are citing all material that is directly quoted, summarized or paraphrased. See the student success center if you are not sure of any of this.

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Business Law and Ethics: How health care entities bill for insurance
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