Insurance coding and billing

 

Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.

 

Sample Solution

Medical billing employs those codes to establish insurance claims and bills for patients, whereas medical coding extracts billable information from the medical record and clinical documentation. Medical billing and coding collide in claim creation to create the backbone of the healthcare revenue cycle. The procedure begins with patient registration and concludes with full payment for all services rendered to patients. Depending on the complexity of services performed, claim denial handling, and how organizations collect a patient’s financial responsibilities, the medical billing and coding cycle can take anywhere from a few days to many months.

Teamwork plays an essential role within both Fiedler’s Contingency Theory and Chelladurai’s Multi-dimensional model particularly regarding leader-member relations, if the group are familiar and trusting of the leader policy implementation becomes much simpler. Similarly to leadership, understanding and adapting to the situation is key to a leader being able to implement policies that ensure a group work as a team. Teamwork is a product of good leadership, and is again the responsibility of the leader to ensure the group are working successfully together. Highly functioning teams are essential within organisations to increase productivity and member satisfaction, by utilising the talents of all group members effectively within the constraints of the task, personal relationships and the group goals (Pettinger, 2007). Figure 2: Tuckman’s Model of Group Development (Agile Scrum Guide, 2019) Tuckman in his Model of Group Development provides easily identifiable stages that a groups performance can be measured against, making it useful for monitoring performance, Figure 2 shows Tuckman’s model. Ranking group performance against this scale can provide leaders with a clear understanding of how the group are functioning, allowing them to implement policies to change this if performance is unsatisfactory (Pettinger, 2007). Within organisations, the theory can be loosely applied to creating teams by grouping familiar individuals with the aim that they will reach the norming and performing stage of the model quicker. For short and simple tasks this is an extremely effective way of organising groups, due to the increased short term productivity. However there are significant issues with grouping individuals in this manner, particularly when tasks become more complex, and ultimately the model should mainly be used for monitoring the progress of groups (Pettinger, 2007). Figure 3: Belbin’s Team Roles (PrePearl Training Development, 2019) A more functional approach of grouping individuals is to utilise Belbin’s Team Theory (Belbin, 2017). Belbin identifies 9 key roles that must be fulfilled within a group to ensure success, the role

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