HCM 301 CSU Health & Medical Healthcare Provider or Facility Paper – Description
Choose a healthcare provider or facility (hospital, clinic, physician, home health, or LTC/SNF) and review the Medicare Claims Processing ManualLinks to an external site. for your chosen selection.
In your paper you will review, analyze, and discuss the following details:
Type of provider and example of service provided.
General guidelines for submitting a claim.
Claim submission formatting (paper or electronic) and form number.
Specific coding requirements.
Claim type and reimbursement arrangement.
Denial and appeals process.
Reference:
CMS.gov. Medicare Claims Processing Manual. https://www.cms.gov/regulations-and-guidance/guidance/manuals/internet-only-manuals-ioms-items/cms018912Links to an external site.
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