The Importance Of Medical Billing Practice

1133 Words 5 Pages
following medical billing considerations are established by the American Medical Association (AMA). However, it is not required by law to adhere to the AMA Principles of Medical Ethics. Every medical facility is necessary to comply with HIPAA laws. If HIPAA is violated, a legal suit will follow.
Confidentiality:
A medical specialist is privy to very private and sensitive patient information. As a result, patient information should only be discussed with the patient, physician, and health insurance provider. Additionally, HIPAA requires healthcare professionals to put several safety measures in place. To pair with HIPAA compliance billing specialists can put a security code on files, face screen away from other clients, and limit patient discussions
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Chi is perplexed about the billing process. Recently Ms. New followed up to see how Mr. Chi was fairing with his bill. Of course, Mr. Chi did the right thing and paid his bill, however, he was stunned when he received the bill for removing Jeremiah 's stitches which only was a charge of twenty dollars. How could this be when the emergency room visit itself cost Mr. Chi several thousands of dollars. Perhaps the utilitarian ethical theory might improve billing practice. Utilitarian ethical theory means “theory supports what is best for most people. The value of the act is determined by its usefulness, with the main emphasis on the outcome or consequences” (nursingworld). Ms. New and Mr. Chi discussed the dilemma and came to the resolve that it could benefit the HCO and patient care. Mr. Chi and Ms. New concluded at the time of the emergency room visit the level of urgency and attention could have been lowered. Thus a change in coding to a lower status, and reduction in HCO charges and patient out-of-pocket costs. Once the medical team realized that the admittance was not urgent could the status change. Thus conflict often arises between providers and payors to find a balance to give the best care while keeping costs

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