Financial Procedures in a Health Care Organization

Task Type: Discussion Board   Deliverable Length: 400–600 words   
Points Possible: 50   Due Date: 4/22/2015 11:59:59 PM  CT [removed]   

Primary Discussion Response is due by Wednesday (11:59:59pm Central), Peer Responses are due by Sunday (11:59:59pm Central).

Primary Task Response: Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Health insurance companies provide the majority of the payment for medical services that clinics and physicians deliver. After the care has been delivered, the medical record is reviewed for completeness, codes are applied, and the billing office submits the claim to the third-party payer or insurance company for payment. Discuss the following:

• What does it mean to submit a clean claim?
• State various reasons for the importance of a clean claim submission.
• Address the consequences of not submitting a clean claim.