Medical Insurance
Part 1
Please explain why the following topics are important for medical billers and coder to understand:
1. Identify the different components of TRICARE billing and different types of benefits available to active duty members, veterans, and their family members.
2. Understand the history of workers’ compensation and distinguish between federal workers’ compensation and state workers’ compensation.
3. Explain the importance of the Explanation of Benefits and Electronic Remittance Advice forms.
4. Understand the reimbursement follow-up, explain the appeals process for reimbursement, and identify refund guidelines.
Please include at least 3 scholarly articles within your response. Overall response will be formatted according to APA style and the total paper should be between 2-4 double spaced pages not including title page and reference page.
Part 2
Response should be formatted according to APA style. 150 words, minimum for each question.
1. Describe the requirements for Tricare?
2. Discuss the negative effects of these 2 types of insurance fraud
a. Performs services that exceed what's medically necessary
b. Misrepresents services that are billed to Medicare