Capstone Checkpoint hcr240

Capstone Checkpoint hcr240 - Capstone Checkpoint Yolanda...

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Capstone Checkpoint Yolanda Campos HCR/240
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Claims adjudication is a claim process, which is important in billing and reimbursement. Claims are track by medical insurance specialists, which are due, payments, paid correctly, and filed with secondary payers. The first step is initial process is checked by processing a system by the payer’s front-end claims. Paper claims or any attachments are date-stamp and enter into the computer, entering personal data or using a scan system. When doing initial process, there are issue they may run into such as patient name, identification number, service code are wrong, or diagnosis code is missing or invalid, and the gender of the patient is incorrect. When errors or simple mistake are made, claims can be rejected and the medical insurance specialist should respond quickly and correct the errors to re-bill the service. The second step is called automated review checks if the patient are eligible for service,
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This note was uploaded on 08/25/2011 for the course HCR 240 taught by Professor Drdiegel during the Spring '11 term at University of Phoenix.

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Capstone Checkpoint hcr240 - Capstone Checkpoint Yolanda...

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