HCM 301 CSU Health & Medical Healthcare Provider or Facility Paper

Choose a healthcare provider or facility (hospital, clinic, physician, home health, or LTC/SNF) and review the

Medicare Claims Processing ManualLinks to an external site.

for your chosen selection.

In your paper you will review, analyze, and discuss the following details:

Type of provider and example of service provided.

General guidelines for submitting a claim.

Claim submission formatting (paper or electronic) and form number.

Specific coding requirements.

Claim type and reimbursement arrangement.

Denial and appeals process.

Reference:

CMS.gov. Medicare Claims Processing Manual.

https://www.cms.gov/regulations-and-guidance/guidance/manuals/internet-only-manuals-ioms-items/cms018912Links to an external site.

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