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BASIC BILLING AND REIMBURSEMENT STEPS
Terms in this set (9)
COLLECT PATIENT INFORMATION
gathering and verifying information about the patient
this is the verification of the patient's eligibility for benefits before services are provided
PREPARE THE ENCOUNTER FORM
encounter form should reflect the diagnosis and services provided to the patient. This is used as the basis for billing.
CODE DIAGNOSIS AND PROCEDURES
diagonosis and procedures documented in the patient's record are converted to Cpt, Icd, Hcpcs codes.
REVIEW LINKAGE AND COMPLIANCE
includes the following:
appropriateness of codes
link between the diagnosis and the procedure
payer's rules about diagnosis and procedure
documentatin of the procedure
compliance with regulation
calculate physician charges
prepare a standard paper or electronic CMS1500 form
electronically submit or mail completed CMS 1500 form to third party payer or clearinghouse.
FOLLOW UP REIMBURSEMENT/RECORD RETENTION
all payment transactions are checked to compare the claim sent and reimbursement received.
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