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This scenario is for a non-participating provider who contracts with Medicare. Prior to determining the limiting charge, you must first decrease the PFS amount by 5%. More information is available to you in Chapter 9 of your text, pages 322-330. Use the attached document to complete and submit for grading.
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In the 1970’s, Detective Serpico “broke the ranks” and exposed police corruption in the New York City Police Department. As a result, he was shot in the face, and it is his belief that he was set up by his colleagues — officers charged with the protection of the citizenry. Do you believe the subculture…
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The remittance advice is a key document that reimbursement specialists use daily on the job. This document, whether in an electronic or paper form, provides essential information that helps us to effectively perform the job duty of applying insurance reimbursement to patient financial accounts. Illustrate your knowledge of the components and use of the electronic…
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There are many important details that are entered on a CMS 1500 claim form for a patient’s services that were rendered by a provider. Information added to the claim form is electronically captured within the practice management system and electronic health record that is used by the medical office. Medical coders and reimbursement specialists are…
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Assign the appropriate CPT E & M level, procedures and ICD-10-CM code(s) for the physician office encounter. When there are multiple CPT codes, always sequence E & M level first. When there are multiple ICD-10-CM codes, sequence first-listed diagnosis first. This patient was referred by her primary care physician due to complaints of muscle weakness…
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The purpose of this assignment is to evaluate different aspects of team development and collaboration within a health care environment, and to assess how teamwork directly affects patient care and outcomes. Select a specific type of health care facility to evaluate for this assignment. Consider hospitals, clinics, blood banks, birth centers, hospice homes, or other…
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To prepare for your assessment, you will research the literature on your selected health care problem. You will describe the priorities that a care coordinator would establish when discussing the plan with a patient and family members. You will identify changes to the plan based upon EBP and discuss how the plan includes elements of…
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Review this week’s Learning Resources and consider the insights they provide. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video. · Select a child/adolescent or adult patient from your clinical experience that presents with a significant concern. Create a focused SOAP note for…
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What affect does a condition have on the probability? Let’s compare and find out. Example: Let’s look at a standard deck of 52 playing cards. No replacement: What is the probability of getting 2 kings assuming that the first one is not replaced? (Note: There are 4 kings in a deck of cards. And a…
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This week explain who the potential audience for your e-portfolio will be. How will you ensure that your e-portfolio is well received by the audience? What acronyms do you use in your workplace that can cause confusion? If you are including a resume, review your resume for acronyms. Here is an example, CSM= Customer Service…