正确编码和导航付款人的期望
1Graduate School of Continuing and Professional Studies, Washington University in St. Louis.
概括
本评论讨论了医疗保健计费合规方面的挑战,这些挑战是由各种保险要求引起的. 它为健康信息专业人员提供了实用策略,以导航健康保险可移植性和问责法案 (HIPAA) 的合规性.
科学领域:
- 医疗保健管理部门的管理.
- 健康信息管理 管理健康信息
- 医疗账单计费 医疗账单计费
背景情况:
- 不同的付款人要求对医疗保健账单合规性产生了重大障碍.
- 医疗保险可移植性和问责法案 (HIPAA) 规定了统一的代码集,以标准化流程.
- 尽管进行了标准化,但在实现完整的计费合规方面仍然存在挑战.
研究的目的:
- 为了确定发票合规的根本原因和障碍.
- 检查HIPAA下的统一代码集对计费实践的影响.
- 为健康信息专业人员提供可行的建议.
主要方法:
- 对现有法规和行业实践的评论和分析.
- 对健康保险可移植性和问责法案 (HIPAA) 条款的审查.
- 合规的实际策略的综合.
主要成果:
- 违规的根本原因源于复杂和多变的付款人要求.
- HIPAA的统一代码集旨在简化但并没有消除所有合规障碍.
- 积极的战略,监测和政策制定对于有效的合规至关重要.
结论:
- 为了实现一致的计费合规性,需要解决付款人要求的复杂性.
- 卫生信息专业人员必须采取主动和战略方法,以确保符合HIPAA.
- 有效的政策制定和持续监测对于持续的计费合规性至关重要.
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