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· Explain how to determine from the patient which type they subscribe to.

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Week 3 Project

Introduction:

In order to properly code a bill for medical necessity, it is important to understand the electronic medical record. This record contains information about the patient’s health both before and after the treatment and has the data needed to assure a payer that the treatment was necessary.

Tasks:

· Explain the contents of the medical record.

· Describe SOAP notes—subjective, objective, assessment, and plan.

· Explain operative reports function in medical necessity coding.

· Explain National and Local coverage determinations.

Submission Details:

· Submit the report as a 5- to 10-page Microsoft Word document. Use APA standards for citations and references.

· Cite a minimum of three outside peer-reviewed sources to support your assertions.

Week 4 Project

Introduction:

Medicare and Medicaid are federal programs that cover a large proportion of the US population with healthcare. The two have similar objectives in the area of providing care, but there are significant differences in them that concern reimbursement.

Tasks:

· Describe each program, Medicare and Medicaid.

· Provide the major features of each program.

· Discuss how these programs differ from each other.

· Briefly describe the process of how to bill for each program.

Submission Details:

· Submit this topic as a 2- to 3-page Microsoft Word document. Use APA standards for citations and references.

· Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as

Week 5 Project

NCF:

This final project assignment is associated with the NCF (non-completion failure) grade. Failure to complete this assignment will result in the issuance of a grade of NCF if the course average would result in a failing grade in the course. Students should contact their Academic Counselor or Program Director if they have any questions regarding the NCF grade and its implications.

Introduction:

In order to properly code a bill for medical necessity, it is important to understand different plans and the requirements for billing each. It is true that they all use the ICD-10-CM diagnosis coding system, the CPT procedure coding system, and the CMS-1500 form, but each type of carrier has certain requirements for a clean bill.

Tasks:

· Create a billing manual constructed of summaries of each type of insurance.

· Include the major requirements for billing for each type.

· Note inpatient or outpatient differences where appropriate.

· Explain how to determine from the patient which type they subscribe to.

Submission Details:

· Submit this topic as an 8- to 10-page Microsoft Word document. Use APA standards for citations and references.

· Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as
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