Choose a healthcare provider or facility (hospital, clinic, physician, home health, or LTC/SNF) and review the Medicare Claims Processing Manual (Links to an external site.) for your chosen selection.
In your paper you will review, analyze, and discuss the following details:
- Type of provider and example of service provided.
- General guidelines for submitting a claim.
- Claim submission formatting (paper or electronic) and form number.
- Specific coding requirements.
- Claim type and reimbursement arrangement.
- Denial and appeals process.
Your paper should be two to three pages in length (not including the required title and reference pages) and conform to APA standards in CSU Global Writing Center (Links to an external site.). Include at least two scholarly references in addition to the CMS.gov (Links to an external site.) resource.
CMS.gov. Medicare Claims Processing Manual. https://www.cms.gov/regulations-and-guidance/guidance/manuals/internet-only-manuals-ioms-items/cms018912