Reference no: EM13372975

Physician Reimbursement Case:

Physician Services: According to the Centers for Medicare and Medicaid, the 837P (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. The Form CMS-1500 is the standard paper claim form used in billing Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. Also, in addition to billing Medicare, the 837P and Form CMS-1500 may be suitable for billing various government and some private insurers

Hospital Services: According to the Centers for Medicare and Medicaid, the 837I (Institutional) is the standard format used by institutional providers to transmit health care claims electronically. The Form CMS-1450, also known as the UB-04, is the standard claim form used in billing Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. Also, in addition to billing Medicare, the 837I and Form CMS-1450 may be suitable for billing various government and some private insurers.

Submit a file that addresses the following:

Discuss the general differences between facility and nonfacility rates. Discuss the MS-DRG system for hospital inpatient services. Include in your discussion the history of the MS-DRG system and the need for the updated system. There are two types of bills used in healthcare. Which type of bill is used for physician services? Which type of bill is used for hospital services?