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Essay Available:
Pages:
1 page/≈275 words
Sources:
4 Sources
Level:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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MS Word
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3-1 Discussion: Claims Processing and Reimbursement (Essay Sample)

Instructions:

In your post, compare and contrast various payers and suppliers and the claims filing process. How important are ethics with claims processing? Explain how ethics can impact payer mix and reimbursement.
In response to your peers, support their position with additional ideas and concepts from the module's readings. Offer a potential problem that could arise when dealing with claims filing

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Content:


3-1 Discussion: Claims Processing and Reimbursement
Name
Institution
Date
health claims processing and reimbursement
In your post, compare and contrast various payers and suppliers and the claims filing process. How important are ethics with claims processing? Explain how ethics can impact payer mix and reimbursement.  In response to your peers, support their position with additional ideas and concepts from the module’s readings. Offer a potential problem that could arise when dealing with claims filing
The payers involved are the government agencies and the private or commercial payers, and they facilitate payment of services through various programs. Medicare and Medicaid are the largest players in health insurance. Under Medicare there are different plans in parts A, B, C and D, and part A focuses on employment, insurance covers for medications, supplies and services covered by the inpatient or outpatient health care organizations. Part C focuses on health maintenance organizations (HMOs), local preferred provider organizations (PPOs) and the provider sponsored organizations (PSOs). Part D insurance covers access to the low cost prescriptions (Harrington, 2016).
The suppliers refer to the physicians, practitioners or entities other than the providers who furnish healthcare services under the Medicare program (Harrington, 2016). The providers must meet the Medi

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