How medical billing and coding regulations affect reimbursement in a healthcare organization

by | Mar 1, 2023 | Accounting

 

How do medical billing and coding regulations affect reimbursement in a healthcare organization? After reviewing the steps in the revenue cycle, what are the various tasks that the different healthcare departments do to drive the reimbursement process?
1. Discusses health reimbursement issues and includes an accurate and detailed explanation of the key aspects of the topic
2. Provide an in-depth analysis that demonstrates a good understanding of challenges of healthcare reimbursement concepts
3. Conduct comprehensive research that provides examples of scholarly resources and healthcare sector-specific information that support your analysis

 

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Sample Solution

Medical billing and coding regulations affect reimbursement in a healthcare organization by providing the necessary framework for making sure that claims are accurately presented, processed and paid. These regulations provide the rules and guidelines for medical providers to submit accurate claims, follow-up on unpaid or denied claims in a timely manner, keep records of patient visits, etc. The overall goal is to ensure that patients receive appropriate care and get reimbursed accordingly.

 

Sample Solution

Medical billing and coding regulations affect reimbursement in a healthcare organization by providing the necessary framework for making sure that claims are accurately presented, processed and paid. These regulations provide the rules and guidelines for medical providers to submit accurate claims, follow-up on unpaid or denied claims in a timely manner, keep records of patient visits, etc. The overall goal is to ensure that patients receive appropriate care and get reimbursed accordingly.

 

The various steps in the revenue cycle involve submitting claim forms with all relevant information to health insurance companies or government agencies; verifying eligibility for coverage; processing charges; creating bills for services rendered; collecting payments from insurers and patients; managing accounts receivables (AR); following up on denied or unpaid claims; posting payments received; reconciling accounts after each patient visit/provider transaction is completed.

Different departments within an organization have specific tasks they need to complete in order to drive the reimbursement process: Billing Department – submits claim forms with all relevant information such as diagnosis codes, procedure codes, modifiers etc., verifies accuracy of documentation before submission, keeps track of AR status’s etc.; Coding Department – assigns ICD-10-CM codes correctly according to documented diagnoses reports/progress notes provided by medical provider/clinician; Accounts Receivable (AR) Department – responsible for getting payment from insurers or patients when applicable using collection agencies if needed etc.; Claims &Reimbursement Department – processes charges submitted by billing department according insurer’s network fee schedule requirements & ensures timely payment by tracking down any denied or delayed claims quickly etc.; Information Technology (IT) Department – provides critical technical support such as software maintenance updates that enable automatic capture/transmission of data between different departments within hospital etc.

Overall it can be seen that medical billing and coding regulations play an important role in ensuring that health care organizations get reimbursed accurately while upholding quality standards set out by governing bodies. It is crucial therefore that staff have proper training along with adequate systems which allow them execute their respective duties efficiently thereby guaranteeing successful completion entire revenue cycle process benefit both parties concerned involved transactions taking place everyday today’s rapidly evolving healthcare landscape

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