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Revenue and Reimbursement (Example)

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Revenue and reimbursement Student’s Name: Affiliation: Revenue and reimbursement Introduction The current shifting practices in the healthcare industry characterized by consumer-driven healthcare real-time processing and the regulatory changes as well as reimbursement structures have necessitated the need for revenue cycle management. The practice plays a key role in addressing the apparent inconsistencies and streamline the billing policies and procedures in the sector. In essence there is a need for the office manager to provide step-by-step directions for the entire revenue cycle spanning from the pre-verification of insurance to the accounts receivable management. Furthermore in addition to containing an appropriate methodology for determining the pricing structure the billing policies to be developed should incorporate the considerations for negotiating insurance contracts and for private pay and charity care. The best billing policies are necessary to cultivate best practices in the billing system by covering both pre-service and post-service financial clearance and which the medical care providers are in contract with the insurance company to render health care services to patients. To ensure consistency across the office there is a need for a simplified mathematical description which illustrates the loss process based on the number of claims their severity and their timing in occurrence for an appropriate pricing structure. Thus the office manager is obliged to make special considerations when negotiating insurance contracts as well as for the private pay and charity care. The overall process streamlines the billing policies of healthcare providers in optimizing customer services.   References Burgos M. Johnson D. & Keogh J. E. (2016). Medical billing and coding demystified. New York: McGraw-Hill Education Press. Davis N. A. Doyle B. M. & American Health Information Management Association. (2016). Revenue cycle management best practices. Chicago Illinois: AHIMA Press. Parodi P. (2014). Pricing in General Insurance. (Pricing in general insurance.) Hoboken: CRC Press. [...]

Order Description:

Revenue and Reimbursement You just stepped into a new role as an office manager. Due to a lack of consistency throughout the office, you have been asked to update the billing policies and procedures to include the following elements: Step-by-step instructions for the entire revenue cycle from pre-verification of insurance to accounts receivable management. Methodology your office will use to determine a pricing structure. Considerations for negotiating insurance contracts. Considerations for private pay and charity care. Place these in a single Word document, using a typical office policy format. Because you are using a policy format, it is not necessary to include a title page; however, you still need to include a reference page to show how you conducted your research.

Subject Area: Finance

Document Type: Personal Statement

This project has already been completed by one of the Studybay experts. The client rated this project:

Project's rating is 5/5

Price $25

Words 550

Pages 2

Completed in 3 days

Expert SmartMind

Client Review

Awesome work. Assignment completed with 2days and 11hours remaining.


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