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What are the costs and coverage considerations involved in the selection of a plan for medicare coverage?
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- What major factors led to the inclusion of prescription drug coverage under Medicare? Is the insurance purchased directly from the Federal government or from private insurers? What is the annual deductible under the coverage? In percentage terms, what is the copayment for prescription drug expenses below $2250 annually? What percentage of expenses is covered above $3600 annually? Why might the new coverage boost the price of prescription drugs?Describe the four parts to Medicare and why they are important to healthcare organizations.What is the significance of the patient financial responsibility agreement prior to a diagnosis procedure?
- Clinical Documentation Guidelines may be set by various licensing and regulatory agencies, as well as provided as guidelines by professional associations. For the purpose of this discussion, compare and contrast guidelines provided by CMS, NCQA, and AHIMA. You may use the links below for your convenience: CMS: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/CERTMedRecDoc-FactSheet-ICN909160.pdfLinks to an external site. NCQA: https://www.ncqa.org/wp-content/uploads/2018/07/20180110_Guidelines_Medical_Record_Documentation.pdf Links to an external site. AHIMA: Read documentation guidelines in Fahrenholz, Chapter 2https://campus.ahima.org/campus/courses/CB/course_docs/HDCS/HDCS_V3_C2_FunctionsHealthRecord.pdfMedicare and other payers may consider a procedure to be non covered service when performed in an ASC for several reasons. List two detail answer please typedThe Centers for Medicare & Medicaid Services (CMS) is responsible for Accountable Care Organizations (ACOs). Describe one of the types of ACOs available to providers. Reply to at least two (2) classmates, with a minimum of 75 words each post. Why is it so important to accurately code diagnoses and procedures as this relates to the ACOs?
- A. why are there different rate tables for Medicare, insurance companies, workers compensation, employee health, and self-pay visits B. what are the data required to complete sections 21 through 33 of the CMS1500 form?Medicare ACOs and bundled payment programs/strategies rely on the use which of the following organizational structures: Question options: 1) Vertical Integration 2) Horizontal Integration 3) Physician Alignment 4) Vertical Integration and Physician Alignment 5) Horizontal Integration and Physician AlignmentDescribe the projected financial impact the Affordable Care Act (ACA) will have on Medicare spending. Identify the projected financial impact(s) on how the ACA will affect Medicare spending. Be specific on how those impact(s) are projected to change health care and its delivery.
