Financial Resources Management and Healthcare Reimbursement

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A. Evaluate the importance of the following government initiatives as they pertain to the coding function:
1. Medicare and Medicaid Patient and Program Protection Act of 1987
2. Operation Restore Trust
3. Medicare Integrity Program
4. Medicare Prescription Drug Improvement and Modernization Act of 2003: Recovery Demonstration Project
B. Explain the role of a quality improvement organization contracting under the Centers for Medicare and Medicaid Services as it applies to the coding process.
C. Diagram the activities of each step of the revenue cycle in the order in which they occur.
1. Describe the work of HIM staff members during each step of the revenue cycle in which they would be involved.
D. Describe how you would address the following automated billing report errors:
1. The date of service on one portion of the bill for a same-day surgery was not in agreement with the date on other portions of the bill
2. The diagnosis and procedural codes were inaccurate
3. A procedure was billed to the wrong patient
The assignment needs to be presented in the outline format noted above. Material used to research and/or cited should not be older than 3 years as the laws have changed since 2010, and they need to relate to US healthcare system and reimbursement. I normally answer each question on average with 2 paragraphs. At least 3 citations is desired. When you use sources, include all in-text citations and references in APA format.
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