Compare and contrast the various billing and coding regulations researched in Module Two to determine which ones apply to prospective payment systems.

Compare and contrast the various billing and coding regulations researched in Module Two to determine which ones apply to prospective payment systems. Reflect on how these regulations affect reimbursement in a healthcare organization. Assess the impact of regulations on reimbursement in a healthcare organization and explain what you think is working and what could be a challenge. If possible, bring in a real-world example either from your life or from something you have read about.

this is the research did in Module Two

Compliance, Coding and Reimbursement
Billing regulations in healthcare systems affect reimbursement through claims to ensure insurers pay for different services for their insured. Using the billing legislation, facilities submit health insurance claims on behalf of patients (Merritt, 2019). Doing so ensures that they receive funds for the services rendered. Laws affect the process by compelling are settings to have the correct patient details that reduce cases of delayed reimbursement. Besides, the policies also reduce instances of insurance fraud because facilities account for the funds they received to treat patients appropriately.
Coding policies influence reimbursement in recording treatment, injuries, and procedures using the proper alphanumeric codes. The process influences how caregivers bill their patients and charge their insurance companies (Merritt, 2019). For every medical activity they perform, the systems must indicate key details and overall charges. The procedure affects reimbursement in that it prompts hospitals to remain accountable and transparent in the services they offered to patients (Merritt, 2019). The proper coding practices ensure that patients do not pay for services they never received with deductions in their insurance cards.
The reimbursement process compels the customer service, outpatient, and in-patient treatment departments to engage in patient registration, charge transmission, and entry activities. The first practice allows facilities to have the essential records of their patients from the time they go to a hospital, receive services, and pay for the procedures (Merritt, 2019). The next takes place when service providers utilize electronic data interchange systems to document payments. Using the last method, the groups monitor patient services to ensure that the value of money they receive equates to the service (Merritt, 2019). The practice ensures that hospitals have suitable payment posting and revenue claims for their patient populations.

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