1).An overpayment has been made by Medicare for patient josh bok .Determine whet
ID: 464693 • Letter: 1
Question
1).An overpayment has been made by Medicare for patient josh bok .Determine whether a refund should be made. If not, explain the reasoning behind your decision. If so, what steps should be taken to refund the overpayment?
2).why is the reference remark important to a medical practice?
3).Develop a policy regarding ABNS and how they would be used in your medical practice.
4).Design a patient encounter form for a medical practice.(Do not include ICD-9-CM or CPT codes)
5).A long –time patient of the practice has recently fallen on ‘’Hard times’’ and cannot pay the ‘’patient balance due’’after his surgery. How should the office manager handle this patient?
6).An office manager is new to a practice. She discovers that there are several credit balances on the books for a patient. Is it necessary for her to do anything about this discrepancy, or can she allow them to stay there until the patient returns to the office (to use up the credit)?
7). A good friend of the physician arrives for an office visit. The physician instructs the receptionist not to charge this individual. The receptionist comes to the office manager for guidance. How should the office manager handle this situation?
8). Describe the self –disclosure program and how it may be used by a medical practice.
9).Dr.Martin submits claims electronically for services that were not performed. What criminal statute(S) could this practice involve?
Explanation / Answer
Note as per the Chegg policy we can answer maximum 4 questions. Here because of time limitations I have attempted 4 questions only.
Answer :
1) Yes as clearly mentioned overpayment is made that means whatever the extra payment done that needs to be collect back from the source.
Following are the steps
a) Check the record of the patient
b) Call the patient
c) Communicate the mistake
d) Explain in very systematic way
etc
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2) Yes I agree with the statement that Reference remark is very important in medical practice. See in medical practice patient is continually doing the follow up , taking the medical service. Sometimes doctor changes , sometimes hospital changes , sometimes treatment changes .In such case to track the back history of patient reference remark is important.
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3) ABNS Policy
The primary policy of the American Board of Neurological Surgery are to deportment examinations of applicants who voluntarily seek guarantee, and to issue Certificates to persons who meet the supplies of the Board and acceptably complete its inspections. Certification by the ABNS is based on appraisal and evaluation of the applicant's instructive, training, and repetition qualifications, as well as fruitful completion of written and oral inspections. In addition, the Board, along with the Residency Review Committee for Neurological Surgery (RRC) and the Authorization Council for Graduate Medical Education (ACGME), works to refining the standards of exercise in neurosurgical residency programs through the United States.
ABNS operations that movement directly from these main purposes include:
A credential, once granted, is verification of the conclusion of educational, peer review, and inspection processes. The Board certifies as authorities in neurosurgery lone those who voluntarily petition it for the tenacity of evaluation and documentation.
The ABNS is not worried with the acquisition of special freedoms in the repetition of neurosurgery for its Diplomats. It does not describe requirements for membership on the staff of any infirmary, university, or clinic, nor does it effort to elect who shall perform any neurosurgical technique. It specifically disclaims attention in or recognition of any difference remuneration which may be built on certification. Its Certificates do not deliberate any legal degree of requirement, joy, or license to practice neurosurgery. The ABNS does not anticipate to interfere with or perimeter the professional activities of any correctly licensed physician whom it has not skilled
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8)
Self-disclosure program used in hospital for process smoothing.
Following are the contents of self-disclosure program.
Now for the implementation of self-disclosure program it’s very important that hospital needs a support from Top , Middle , Lower level resources. This is not the tool of only one management level.
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