Cristina Thibault Week 2 Project Collapse
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages
Cristina Thibault Week 2 Project Collapse
Centers for Medicare and Medicaid Services also known as CMS and use to be known as Health Care Financing Administration which was known as HCFA. I hear about CMS at my job all the time, so CMS payment
systems are very familiar to me. CMS is an agency within the Federal Department of health and human services. (Green, M. & Rowell, J., p. 729) What this agency does it administered a few different kinds of health
care programs. Some of these programs require reimbursement for services that were provided. Like at my job, if a patient got a colonoscopy or an endoscopy, some require reimbursement, according to the health plans that fall under this. The federal agency uses the PPS system, known as Prospective Payment System, which is a payment of some sort, made which is based on predetermined or fix amounts, no what services
were provided, anywhere from a huge service to the smallest. Some of the health plans that fall under this, is CHAMPVA, Indian Health Services, Medicaid, Medicare, Tricare and Workers comp.
Now to talk about ICD codes. ICD stands for the International Classification of Diseases. This coding is used to classify mortality data from death certificates. (Green, M. & Rowell, J., p 156)
This is coding system for diagnoses, conditions, symptoms and more. These codes are all documents on procedure reports, office visits, etc. It is very imperative that you don’t mess up on this kind of coding because
it can reduce the amount of denials and claim submission better.
ICD-10 codes are more specific then ICD-9. Instead of using one standard coding for a polyp you find on patient, now you have to use an ICD-10 code that specifies exact conditions.
CPT stands for Current Procedural Terminology. This is used to report any medical, surgical and diagnostic procedures performed by the provider.
HCPCS, known as healthcare common procedure coding system is a set of health care procedure codes based on AMS. HCPCS works hand in hand with CPT and can get a little confusing. HCPCS includes three
separate levels of codes: Level I, Level II, Level III. CPT fall under level 1.
Inc., H. (2018, November 1). Note similarities and differences between HCPCS, CPT® codes – www.hcpro.com. Retrieved from http://www.hcpro.com/HIM-284009-8160/Note-similarities-and-differences-between-HCPCS-CPT-codes.html
Green, M. & Rowell, J. (2013). Understanding health insurance: A guide to billing and reimbursement. Clifton Park, NY: Delmar, Cengage Learning.
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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