Based on the lectures and reading this week, claims processing is something a health care leader should know about to do his/her job, as it is essential. A healthcare worker's responsibilities include navigating team situations (difficult or simple), working with HR, fuse substantial amounts of healthcare data, and overall increase access to needed care to their patients. Health care is not cheap and could get expensive since prices are rising and so is the technology in Hospitals and clinics all over. Healthcare leaders could help and look out for their patients by checking if they have health insurance at the time of service, or even checking if they are in network with them, along with checking if there are any less costly ways to get treatment. Processing claims could be lengthy so keeping it organized should limit the confusion and the number of times it is handed off. I agree with Kenya, healthcare leaders and patients should be aware of the ABN form because it is useful for them to know what is or is not covered by the insurance. I think that healthcare providers and patients should understand what the CMS 1500 form is and what it entails. This form shows if the co-payment was collected by the physician or not. This helps the patients from paying extra amounts, but if the patient misses an appointment, then they will be charged still. No matter if they are under Medicare or not. If a patient does get charged extra, some may not be able to continue getting the healthcare they need and might lose their insurance coverage by possibly not paying the missed payments within a certain amount of days.
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