Assignment 5 week 5: Reviewing Computer Operations

Assignment 5 week 5: Reviewing Computer Operations

1. Explain the purpose of having sequential reference numbers on a superbill

The sequence number is used in the identification of documents that match with it according to how it has been posted on the software (Schmitt et al., 2002). The sequential reference number is important in ensuring that record is kept in case need arises for future references.

2. Besides the physician’s office, describe some locations where patients receive medical services from the doctor.

Ambulatory centers, OPDS, polyclinics, non-medical based settings such as camps

3. A physician has treated a patient who has a diagnosis that is not listed on the superbill. How is this handled by the physician?  The medical biller?

It is acceptable for the medical beneficiary to visit another PA/NP if the doctor that begun the diagnosis is unavailable. This only happens if there is the physician is of the same group and has the ability to handle the diagnosis for the same patient and provides the necessary supervision (Bell et al.,2011). The physician can write in the section of diagnoses not listed section in the superbill and then code the written diagnosis for necessity.

4. Explain the purpose of the Advance Beneficiary Notice (ABN).

Advance Beneficiary Notice is considered as a primary insurance for the Medicare physicians. The physicians offer to the patient as a notice that the Medicare suppliers and providers are obligated to offer an Original Medicare enrollee but when they find that the Medicare does not offer the services the enrollee then requests (DiSantostefano,2009). Through the ABN the medical beneficiaries are allowed to take more responsible necessity for their healthcare.

5. Explain the importance of having authorization from a health plan when providing and billing for services.

If the medical beneficiary has a health plan, the physician has to contact the insurance company and explain to them the services that will be offered. This will then enable the insurance company to deny or authorize services.

References

Bell, B., & Thornton, K. (2011). From promise to reality: achieving the value of an EHR: realizing the benefits of an EHR requires specific steps to establish goals, involve physicians and other key stakeholders, improve processes, and manage organizational change. Healthcare Financial Management, 65(2), 51-57.

DiSantostefano, J. (2009). Advance Beneficiary Notice of Noncoverage. The Journal for Nurse Practitioners, 5(2), 124-125.

Schmitt, K. F., & Wofford, D. A. (2002). The financial analysis projects clear returns from Electronic Medical Records: Demonstrating the economic benefits of an electronic medical record is possible with the input of staff who can identify the technology’s benefits. Healthcare Financial Management, 56(1), 52-58.