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Healthcare Insurance Coding, Billing, and Reimbursement

Introduction:
In order to properly code a bill for medical necessity, it isimportant to understand different plans and the requirements forbilling each. It is true that they all use the ICD-10-CM diagnosiscoding system, the CPT procedure coding system, and the CMS-1500form, but each type of carrier has certain requirements for a cleanbill.

Tasks:
Create a billing manual constructed of summaries of each type ofinsurance.
Include the major requirements for billing for each type.
Note inpatient or outpatient differences where appropriate.
Explain how to determine from the patient which type they subscribeto.

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Patrina Schowalter
Patrina SchowalterLv2
29 Sep 2019

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