Process Billing/Coding Scenario


The process of reimbursement involves many responsibilities. For this writing assignment, imagine you are a reimbursement specialist in a physician’s office. In a one-page essay, describe the process of reimbursement step by step, starting at the point that the services have been coded and ending when the claim is paid in its entirety. Select one type of insurance (Private insurance such as Blue Cross/Blue Shield, or Medicare, Medicaid, etc.) and use it while completing your paper. Enter your work into a Word document named “BillingProcess”.
Include at least the following in your document:
Claims completion (CMS-1500)
Describe the key pieces of the information needed, in a list
What should go into Box 1
What should go into Box 2
The claim verification process
Claims payment, including:
Verification/accuracy of payment
Possible rejections and how to appeal them
Payment posting
Billing/collection from patients
Note: Write the paper as if they are instructions for a new employee.

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