Chapter 9, Problem 20R

Ellen Armstrong, cmas (amt), is responsible for all patient insurance billing procedures, Ellen has the following information: Total charges Allowed charges Office visit $150.00 $100.00 Return visit $80.00 $75.00 Deductible has not bee satisfied. Calculate the patient's correct billing if the provider accepts assignment. Calculate the patient's correct billing if the provider does not accept assignment.

Describe what a computerized provider order entry (CPOE) system is. Would you say it diminishes medication errors or it makes it more complicated and creates more errors for the nurse. Provide concrete examples to illustrate your point.

You attended an in-service education program about the outpatient prospective payment system (OPPS) where you learned that certain Medicare Part B services are paid according to ambulatory payment classifications (APCS), which group services according to similar clinical characteristics and in terms of resources required. A payment rate is established for each APC and, depending on services provided, hospitals may be paid for more than one APC for a patient encounter. As part of the in-service, you are provided with the following information and required to answer each question by applying the formula to calculate APC payments. Outpatient Prospective Payment System (OPPS) Formula (APC Weight x Conversion Factor x Wage Index) + Add-On Payments = Payment NOTE: When a patient undergoes multiple procedures and services on the same day, multiple APCS are generated and payments are added together. APC software automatically discounts multiple APC payments when appropriate (e.g., bilateral…