Homework Help: health

Posted by Anonymous on Friday, June 25, 2010 at 6:42pm.

You’re an HMO director. You would like to ensure that you managed care plan is meeting industry standards. What’s one way that you can do this?

You work for a third-party payer performing medical records review. Your job is to match codes that were submitted on the claim to documentation in the medical record. You notice that a code has been input for colonoscopy procedure, but you don’t see the procedure report anywhere in the record. As the third-party payer representative, what will your action are regarding the code that was submitted on the claim form?

health - SraJMcGin, Friday, June 25, 2010 at 6:57pm
1. Try some of the following links:

http://search.yahoo.com/search?fr=mcafee&p=how+can+an+HMO+director+ensure+the+managed+care+plan+is+meeting+industry+standards

2. Try the following:

http://search.yahoo.com/search?fr=mcafee&p=if+a+code+is+submitted+on+the+claim+form+without+the+procedure+report%2C+what+action+do+you+take

Sra

Answer this Question

Related Questions

reimbisement methodologies - You're an HMo director. you would like to ...
medical billing/coding - You're an HMO director. You would like to ensure ...
reimbursement methodologies/ Penn Foster - Your an HMO director. You would like ...
Health care - Please check my answer thanks :) Pick pick the best answer to the ...
HMO - Please check my answer thank you You belong to an HMO By paying the HMO ...
methodologies - hmo director wants to know ifmanaged care plan meets industry ...
Reimbursement Methodologies - Would someone check my answers please, thanks for ...
health care - Can mental illness be cured? o Has the concept of ...
reimbursement methodologies - Can someone please double check my answers. Any ...
health-care - From the perspective of a caregiver, would you prefer traditional ...

For Further Reading

First Name:
School Subject:
Answer: