Insurance Plan For Medicaid And Medicare Essay

1122 Words Aug 8th, 2015 null Page
The two insurance plans I picked are Medicaid and Medicare. I decided to go with these two insurance plans because I have worked with both in a retail pharmacy setting. As with all insurance companies there are certain guidelines and rules to follow. Medicaid and Medicare have many rules and regulations that have to be followed to get a paid claim when billing. While working in the retail pharmacy setting the only time I had to use diagnosis codes were for Medicare B prescriptions. Medicaid Overview Medicaid insurance is a federal and state funded insurance plan for individuals or families with low income (, para 1). This healthcare program was developed in 1965 to help provide medical care to families and individuals with low income (para 1). It is very important when coding any claim that you correctly code it, but especially with Medicaid claims because that can hold up the reimbursement and possibly cause the claim to not be paid for in reasonable time (para 6). Some abbreviations that are good to know when billing and coding for Medicaid:
HIPAA: Health Care Portability and Accountability Act
HCPS: Codes that are used to code health care reimbursement claims
CHIP: Children’s Health Insurance Program
NCCI: National Correct Coding Initiative
PCP: Primary Care Provider
CMS: Center for Medicare and Medicaid Services
PPACA: The Patient Protection and Affordable Care Act of 2010 These are just some of the abbreviations that are used in…

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