Procedure Posting Routines
Assignment: Reviewing Computer Operations
- Explain the purpose of having sequential reference numbers on a superbill (encounter form).
- Besides the physician’s office, describe some locations where patients receive medical services from the doctor.
- A physician has treated a patient who has a diagnosis that is not listed on the superbill. How is this handled by the physician? The medical biller?
- Explain the purpose of the Advance Beneficiary Notice (ABN).
- Explain the importance of having authorization from a health plan when providing and billing for services.
Expert Solution Preview
Introduction: In this assignment, we discuss the procedures involved in posting routines in medical billing. We will answer five questions related to reviewing computer operations.
1. Explain the purpose of having sequential reference numbers on a superbill (encounter form).
Answer: The sequential reference numbers on a superbill are used to track patient encounters and facilitate accurate medical billing. Each service provided by the physician is assigned a unique reference number, which is then used in conjunction with patient demographic information to generate claims. The sequential numbering also helps to identify missing or duplicate claims.
2. Besides the physician’s office, describe some locations where patients receive medical services from the doctor.
Answer: Patients receive medical services from doctors in a variety of settings, including hospitals, outpatient clinics, urgent care centers, and diagnostic centers. Additionally, doctors may provide telemedicine services, which allow patients to receive care remotely via video conferencing or other technology.
3. A physician has treated a patient who has a diagnosis that is not listed on the superbill. How is this handled by the physician? The medical biller?
Answer: If a diagnosis is not listed on the superbill, the physician should add it manually. This can be done by writing the diagnosis on the superbill or by using an electronic medical record system to add the diagnosis code. The medical biller will then use the added diagnosis code to generate a claim for the service.
4. Explain the purpose of the Advance Beneficiary Notice (ABN).
Answer: The Advance Beneficiary Notice (ABN) is used to inform Medicare beneficiaries that a service or procedure may not be covered by Medicare. The purpose of the ABN is to obtain the patient’s signature, acknowledging their understanding that they may be responsible for payment if Medicare denies coverage for the service. This helps to protect providers from liability for services that may not be reimbursed by Medicare, and it allows patients to make informed decisions about their healthcare.
5. Explain the importance of having authorization from a health plan when providing and billing for services.
Answer: Authorization from a health plan is essential to ensure that services provided by healthcare providers are covered by the patient’s insurance plan. Without prior authorization, healthcare providers risk not being reimbursed for services provided to the patient. Additionally, obtaining prior authorization ensures that the patient’s insurance plan covers the service, which helps to prevent unexpected medical bills for the patient.
