Major Issues Hospitals Have in Insurance Coverage
Your book talks about adverse selection as a major issue for insurance providers. Using some external resources as well as your book, discuss the major issues hospitals have in relation to insurance coverage, and how health care reform intends on addressing some of those issues.
- Write a minimum of 250 and a maximum of 350 words.
- Support your post by citing one reference (other than the text) in the discussion.
- Submit your original post by Thursday before midnight EST.
- Respond to at least 1other post by Sunday before midnight EST.
- Failure to submit posts in a timely manner, meet the assigned minimum word count, include citations and references for external sources, or respond to an instructor or peer comment will result in loss of points.
- Note: Cite paraphrased information obtained from another source but do not use quotes. Do not use any quoted or copied material.
Standard HSA Discussion Grading Guidelines
- To avoid point loss, carefully follow all assignment instructions and the HSA Discussion Rubric (5 points).
- Review this Discussion Sample to get a better sense of what is expected of your discussion content and participation.
- Note that responses to instructor comments do not count toward the minimum number of peer replies
- Provide properly formatted citations/references for all source material (see APA 7th Basics Guide and the other library resources).
- Note:For all discussions, students must submit their initial post before any other students' posts will be visible.
Module 2 Discussion: Real-World Problems
Student's Name
College/University
Course
Professor's Name
Due Date
The significant issues hospitals have concerning insurance coverage include medical billing and coding. Medical classification or medical coding entails transforming medical procedures and diagnosis descriptions into statistical codes that are universally recognized and deciphered. Medical billing and coding incorporate procedures and diagnoses derived from diverse medical sources such as physician's notes, radiological tests, and laboratory results. Under the fee-for-serve reimbursement model, patient diagnosis and procedures done on patients are the basis for insurance claims (Rieter & Song, 2018). Therefore, proper coding of healthcare services is a prerequisite for correct reimbursement. Claims denials,