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Journal Entry #2

 

Due by Sunday, 11:59 P.M.

Compare and contrast the various billing and coding regulations researched in Module Two Journal Entry. You're to:

  • Determine which billing and coding regulations you chose for your Module Journal Entry; and then,
  • Decide which coding and billing regulations apply to prospective payment systems (PPS). 

Make sure in this journal entry that you:

  • Reflect on how these regulations affect reimbursement in a healthcare organization. 
  • Assess the impact of regulations on reimbursement in a healthcare organization and explain what you think is working and what could be a challenge. 
  • If possible, bring in a real-world example either from your life or from something you have read about.

If your billing and coding regulations from your journal entry in Module Two do not apply to a prospective payment system, do not be alarmed.  This is okay.  Make sure that you state which billing and coding regulations do and/or do not apply to a prospective payment system.  For those billing and coding regulations that do apply to a prospective payment system; make sure to state the payment system.

 

If your book lacks details on the various PPS in the health care industry, I would suggest visiting the following website:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS018912.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=ascending 

 

On the CMS website, under Internet Only Manuals (IOM), Publication 100-04, contains claims processing manuals on the various PPS systems.  This information will help you with this week's journal assignment.  Within the specific PPS manual, contains content for you to compare and contrast and determine if your three billing and coding regulations apply.  I highly recommend visiting and using this resource for this journal assignment. 

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