Description
COURSE DESCRIPTION
Module 3 outlines ethical standards for documentation requirements specific to each insurance type. It discusses ethical guidelines for Insurance Verification, the Advance Beneficiary Notice (ABN), the GA modifier, the Good Faith Estimate, Superbill, and other essential forms and office procedures. It clarifies the ethical billing guidelines for in-network and out-of-network, the legalities of payment collection, and write-off rules. Lessons from published audits and legal compliance with care pathways will be discussed in detail. Learners will master the professional correspondence competencies relevant to claim denials, such as writing the Appeal Letter. Templates of the associated forms and office policies will be reviewed.
COURSE LEARNING OUTCOMES, GOALS & OBJECTIVES
- Demonstrate Knowledge of Ethical Billing to Insurance
- Understand Insurance Company Types and Documentation Specifics to Each of Them
- Demonstrate Knowledge of Documentation Guidelines for Insurance Explanation of Benefits, Payment Recoupment, and Ethical Write-Offs
- Demonstrate Knowledge of Documentation Preparation for an Audit and Claim Appeal
REQUIRED TEXTBOOKS & EDUCATIONAL MATERIALS:
- The Traditional Medicine Clinical Practice Manual Textbook (is printed on demand, and ships directly from the publisher. Please allow at least 2 weeks for delivery.)
- The Traditional Medicine Clinical Practice CLINIC and OFFICE Policies & Procedures Downloadable Manual
A discount for educational materials is available upon purchase of the class: to get your coupon, please email: GR@AsianTherapies.org
