- Explain the purpose of having sequential reference numbers on a superbill (encounter form).
Medical officers are allowed to share for purposes of recording. The sequential numbers are important in identifying the document that has been posted on the software and the services (Kaniadakis, 2014). The purpose of having a sequential number on a superbill is because it allows easy matching and identification of the documents to the services that have been posted. Through this, it is made easier for correction of the bill and also ensuring bookkeeping and fewer errors occurring.
- Besides the physician’s office, describe some locations where patients receive medical services from the doctor.
Some other locations include Hospital emergency room, urgent care facility, nursing home, Home health specialty clinics, ambulatory surgery centers, OPDS and non-medical institution-based setting where doctors visit.
- 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?
If the physician that begun the treatment is not available, it is allowed that the patient is attended to by the NP/PA as long as there is no physician from a similar group that can offer the necessary supervision. In this case, the doctor can add it to “Diagnosis not listed” of the superbill section (Teagarden, Clotz, Angaran, and Kenreigh, 2000). Then, the medical biller will code and record in writing the diagnoses if they find it necessary
- Explain the purpose of the Advance Beneficiary Notice (ABN).
The purpose of ABN is that it offers advice on the Medicare beneficiaries that specific procedures that may not be covered by the Medicare or will deny the claims for certain services (Centers for Medicare & Medicaid Services, 2014). This, therefore, gives the chance to the patient to take a significant active role in healthcare that they will receive. They have the role of having the treatment, services or procedures, but they will be aware of payments that will be made out of pocket
- Explain the importance of having authorization from a health plan when providing and billing for services.
When a healthcare provider needs prior authorization for the procedures and services it means that the office staff has to contact the insurance company in order to explain to the insurance company on what service they are offering to the patient. The insurance company then has the mandate to either authorize or deny the services offered. If they accept the service, an authorization number is sent to the medical officer and the authorized dates.