Week 1 Project

Introduction:

Given the complexity of the types of financing entities covering the cost of healthcare in America, it is critical to understand the types and their similarities and differences. This project will assure that they are enumerated and understood.

Tasks:

· List at least six types of coverage organization from single-payer to universal coverage.

· Describe their main features.

· Contrast them from the standpoint of billing.

· Distinguish the public-financed types from the commercial-type coverage in terms of regulations.

Submission Details:

· Submit this topic as a 2- to 3-page Microsoft Word document. Use APA standards for citations and references.

· Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as SU_HCM1201_W1_Project_LastName_FirstInitial.doc. Submit the document to the Submissions Area by the due date assigned.

· Cite any sources using correct APA format on a separate page.

Week 2 Project

Introduction:

While it is true that the CMS-1500 claim form may not be used for private-pay patients, this form will be required for all claims when the patient is covered by any form of insurance to recover payment for services. A working knowledge of the CMS-1500 is essential for all persons working in the revenue and billing area of healthcare.

Tasks:

· Using the CMS-1500 form , fill out the form for a non-Hodgkin’s lymphoma (page 183 of text) and a radiological Oncology treatment (page 278 of text). For assistance with completing and saving a PDF document, please click here

· Use patient information found on EOB Figure 4-17 of text (page 90).

· Describe the process of submitting this claim form through a third-party administrator.

Submission Details:

• Submit both the completed claim form and a 1- to 2-page reflection on the process as a Microsoft Word document. Use APA standards for citations and references. • Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as SU_HCM1201_W2_Project_LastName_FirstInitial.doc. Submit the process to the Submissions Area by the due date assigned. • Cite any sources using correct APA format on a separate page.