Discuss the reimbursement follow-up, explain the appeals process for reimbursement, and identify refund guidelines.

Discuss the reimbursement follow-up, explain the appeals process for reimbursement, and identify refund guidelines.

Please include at least three scholarly articles within your response. Overall response will be formatted according to APA style and the total assignment should be between 4-6 pages, double spaced not including title page and reference page.

Please explain why the following are important for medical billers and coder to understand:

Part 1

1. Explain the components of physician medical billing

2. Identify the differences between inpatient and outpatient hospital billing and describe the UB-04 hospital claim form

3. Discuss Medicare fee schedules, provider reimbursement, fraud, and abuse

4. Explain Medicaid eligibility and benefits and the process of submitting Medicaid claims

Part 2

5. Identify the different components of TRICARE billing and different types of benefits available to active duty members, veterans, and their family members.

6. Explain the importance of the Explanation of Benefits and Electronic Remittance Advice forms.

7. Discuss the reimbursement follow-up, explain the appeals process for reimbursement, and identify refund guidelines.

8. Discuss the history of workers’ compensation and distinguish between federal workers’ compensation and state workers’ compensation.

Please include at least three scholarly articles within your response. Overall response will be formatted according to APA style and the total assignment should be between 3–4 pages, not including title page and reference page.

Explanation & Answer

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