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2-3 paragraphs needed only for this assignment, please list references.... see directions below
XXXXXXXXXXPayment Systems

Compare and contrast the various billing and coding regulations. Determine which ones apply to prospective payment systems. 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

Sumita Mitra · Accepted Answer

1
Billing and coding regulations:
Healthcare organisations must follow government laws and standards in order for their operations to run smoothly. Every aspect of healthcare, including billing and coding, is affected by these standards. Providers should understand their involvement in reimbursement as well. Providers are responsible for ensuring compliance with all applicable laws and policies. When there is a conflict with a claim, the golden rule in healthcare billing and coding departments is to not code or bill for it unless it is recorded in the medical record. Providers use clinical documentation to explain reimbursements to payers. The government has also passed legislation that governs the medical business.
 HIPAA from the above mentioned lot is the most important of these new legislation. In general, there are closed, open and isolated type of billing systems in healthcare. Because national code sets and diagnosis-related groups go hand in hand,

2-3 paragraphs needed only for this assignment, please list references.... see directions below XXXXXXXXXXPayment Systems Compare and contrast the various billing and coding regulations. Determine...

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