HCM345 Journal 2
There are tight regulations in the discipline of medicine as evidenced in both developing and developed countries. Most governments ensure that the medical sector has enough resources to improve the quality of healthcare services offered to patients. Medical and healthcare analysts claim that the medical sector is regulated excessively. Regulation in this sector takes place via the use of laws that determine medical and payment procedures in healthcare institutions. Billing codes are efficient in ensuring that a healthcare organization assesses its financial performance efficiently. There are billing and coding regulations that impact different healthcare organizations uniquely.
Billing and coding regulations are expected to improve processes of reimbursements in healthcare institutions. Hospitals and different medical practitioners use the coding information of a patient to provide healthcare services. The accuracy of the codes issued to patients determines success in accessing quality medical services in multiple healthcare institutions. For instance, the ICD-10 code is used by healthcare institutions for billing and providing services to referred medical cases (Buck, 2016). Details of a treatment process are important in billing and coding among healthcare institutions. Nurses and doctors are expected to ensure that details of patients, including their billing codes, summarize important information regarding the condition and payment status of a patient. Billing and coding regulations with reimbursement effects include:
- Health Insurance Portability and Accountability Act (HIPAA).
- Contracts with Health Insurance Companies.
- Medical Billing Fraud.
Using codes effectively promotes fast reimbursement processes in most healthcare institutions. The use of coding promotes billing in that patients access medical care with ease and on time. Medicaid has been effective in the U.S. as it provides a coding structure which integrates medical and payment information (Buck, 2016). Similarly, Medicare also plays a substantive role in ensuring that Americans access healthcare services despite financial restrictions or social status. It is recommendable that the public and authorities take decisive steps in promoting improved medical care in their country. Enrolling on healthcare programs with efficient models for billing and coding would be suitable among citizens with economic constraints.
Buck, C. J. (2016). Step-by-Step Medical Coding, 2017 Edition-E-Book. Elsevier Health Sciences.