I called several different facilities to gain an insight on the process that one has to go through to get a bill paid from services rendered. After deep consideration I decided to speak with a coder by the name of Naomi at Sacred Heart Hospital her first inclination to me was the importance of their job and the steps and processes that they have to go through from start to finish making sure that the hospital and doctors get paid in a timely manner and about the changes that have occurred in regards to how the codes are set up. They no longer use the ICD-9 for CPT they have went to ICD-10 because it is a much easier process that catches errors more accurately. This is done electronically and goes directly to the provider so that their portion
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Once the provider receives the bill they check for any errors and subtract the amount that is required. If there is anything that is left once they take out there portion it is sent to a second provider or the patient. The patient is given 90 days to comply or pay the bill if the hospital receives no payment there next set is to send the payment to a collection agency to retrieve payment.
Charging and Pricing differentiations for other Industries Many feel as though the root of our problem in healthcare stems for not having a center based approach to services regarding healthcare. They feel as though it needs to be more of a market based approach. According to Frakt, A., 2010, consumer-directed health plan and are at the center of this concept. Other industries feel that if you spend more of your own money that the prices will become lower in the end.
This is unrealistic when it comes to healthcare. Many individuals cannot afford to spend their own money for lack of having any extra. That is why there is an enormous amount of individuals that receive services from Medicare, Medicaid and other payers. Because of lack of money or proper job security which in turn makes it harder for them to be able to afford a private payer if everyone received universal care there would not be any need for these other service providers.
Once the provider receives the bill they check for any errors and subtract the amount that is required. If there is anything that is left once they take out there portion it is sent to a second provider or the patient. The patient is given 90 days to comply or pay the bill if the hospital receives no payment there next set is to send the payment to a collection agency to retrieve payment.
Charging and Pricing differentiations for other Industries Many feel as though the root of our problem in healthcare stems for not having a center based approach to services regarding healthcare. They feel as though it needs to be more of a market based approach. According to Frakt, A., 2010, consumer-directed health plan and are at the center of this concept. Other industries feel that if you spend more of your own money that the prices will become lower in the end.
This is unrealistic when it comes to healthcare. Many individuals cannot afford to spend their own money for lack of having any extra. That is why there is an enormous amount of individuals that receive services from Medicare, Medicaid and other payers. Because of lack of money or proper job security which in turn makes it harder for them to be able to afford a private payer if everyone received universal care there would not be any need for these other service providers.