Human Resource Management
Choose a health care provider or facility (hospital, clinic, physician)
Choose a health care provider or facility (hospital, clinic, physician) and create a sample claim for a patient who received care from that provider or facility. Then, write a short paper in which you trace the claim through the claims process, including at least one level of appeal.
Be sure to include the following details:
Type of provider
Type of insurance (private or Medicare)
Services provided, including diagnosis and medical code
Form used to submit the claim
Claim type and reimbursement arrangement
Reason for initial denial/appeal and steps taken to address it