W2: Reimbursement Job Aid - Research Summary Health, Medicine Essay
Imagine that you work as a billing/coder at a University Hospital. Your coding manager asks you to make a job aid to help all new coders understand the different reimbursement methodology based on the patient setting where the care was provided. Specifically, your coding manager requests that new coders use this job aid as a guide to better understand why the code sets assigned for each patient type are used with respect to reimbursement. With this job aid, the coders will be able to reference the care settings and associated reimbursement methodology.
ASSIGNMENT:
Conduct research to find at least ONE credible source on reimbursement methodologies in the various care settings. This source will serve as a reference in your job aid.
Write a brief summary of the source you identified. This summary should contain the following items:
Title and author of the source: Include any credentials the author holds. If this source is from a website, include the link to the website.
What is the main point of your source (article, website, or book)?
Summarize the source by stating all the main ideas of the source.
Why is this source a good choice to help you complete the job aid?
Students’ Name:
University Affiliation:
Course:
Date of Submission:
Reimbursement Job Aid - Research Summary
Article: Paying healthcare providers: The impact of provider reimbursement on the overall cost of care and treatment decisions
Link: https://axenehp.com/paying-healthcare-providers-impact-provider-reimbursement-overall-cost-care-treatment-decisions/
The article authored by Joshua Axene, ASA, FCA, MAAA, a consulting Actuary at Axene Health Partners, LLC, is based in AHP’s Murrieta, CA office. The article illustrates the dynamic nature of how healthcare receives their work reimbursements, how the phenomenon has received reforms and gained popularity in daily discussions (Joshua, 2019). It also explains the different methodologies used in reimbursement in medical settings, including the traditional and emerging methods.
The traditional model of reimbursement includes the fee for service, bundled payment, and capitation. A fee of service postulates that a medical provider obtains revenue based on any procedures they perform. Income received depends on the t...
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