Assignment 4: Reviewing Computer Operations

1. Explain the purpose of having sequential reference numbers on a superbill (encounter form).

The medical officers can share or part super-bills for the purposes of recording in the case that they need the superbills for future references (Schmitt et al., 2002). This, therefore makes sequential references important in making future references for the bills hence being easily retrievable.

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

The family practice centers, the health department, and hospitals

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?

A medical coder applies code after the patient has checked out. In this case any other physician is allowed to attend to the patient when the physician that begun the diagnosis is not available (Bell et al., 2011). In a case that the diagnosis is not listed in the patient’s clinic’s superbill, the physician should assign a diagnosis code in the patient’s super bill with the use of (ICD-9) codes for billing.

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

This is referred to as a notice that the provider should present before receiving the service, that is based on the Medicare coverage rules (DiSantostefano,2009).  ABN advises the patients that some of the procedures may not be provided by the Medicare. ABN is received when one has an original Medicare but not when one has a Medicare Advantage plan. This allows one to decide on where they should get their care and also accept the financial responsibility if it has been denied by the Medicare.

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

If the health practitioner does not have an authorization from the health plan for some prior treatments one might not be compensated by the insurance company. The physician can attend to the patient with great assurance and confidence while having the billing 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.