Week 3 – DQ
Valerius, J., Bayes, N., Newby, C., Blowchowiak, A. (2012). Medical Insurance, an Integrated Claims Process Approach. (6th Ed.), New York, NY: McGraw-Hill Publishers.
Valerius, J., Bayes, N., Newby, C., Blowchowiak, A. (2012). Medical Insurance Workbook. New York, NY: McGraw-Hill Publishers.
Week 3 Discussion:
An error in a form can delay payment to a healthcare provider, so it is important to submit a “clean” orerror-free claim to the appropriate payer. In your healthcare education you have learned about a variety of public and private payers like Medicare, CHAMPVA, and Blue-Cross/Blue Shield, among others. Each has its own requirements for information required for billing to be provided in a claims form.
To Prepare for the Assignment:
With these thoughts in mind:
Post your primary response to DQ1 by Day 3: Choose two payers (e.g. Blue Cross/Blue Shield & Medicaid). Compare and contrast the requirements and differences in the fields required for these two payers. Finally, what 2-3 items would you double check to ensure you have a “clean claim” prior to submitting for the reimbursement?
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