1. how healthcare charging and pricing processes are different from

1. how healthcare charging and pricing processes are different from.

Select a provider or health care facility coder/biller to interview and review the process they go through to satisfy reimbursement requirements for billing purposes.

Write a paper of 750 words that describes the processes that are utilized in producing a final bill. Include in the paper:

1. How healthcare charging and pricing processes are different from those in other industries.

2. How private and government insurers and payers impact actual reimbursement.

3. Cite a minimum of three references to support your rationale.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. 


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ssay     Report on Interview with a Health Care Coder/Biller with the Difference     Between Charging/Pricing Processes in Health Care vs. Other Industries, and     Impact of Government and Private Insurers and Payers on Actual     Reimbursement

Does not     demonstrate an understanding of the business concepts involved in the     issue, including the implications. Does not address process differences and     reimbursement impacts as specified in assignment. Does not demonstrate     critical thinking and analysis of the situation, and does not develop     effective answers to the questions, with rationale.

Demonstrates only     minimal understanding of the business concepts involved in the issue. Only     minimally addresses process differences and reimbursement impacts as     specified in assignment. Demonstrates only minimal abilities for critical     thinking and analysis of the case study, and develops weak answers to the     questions, with minimal rationale

Demonstrates     knowledge of the business concepts involved in the issue, but has some     slight misunderstanding of the implications. Satisfactorily addresses     process differences and reimbursement impacts as specified in assignment.     Provides a basic idea of critical thinking and analysis for the questions,     answers, and rationale. Does not include examples or descriptions.

Demonstrates     acceptable knowledge of the business concepts involved in the issue.     Satisfactorily develops process differences and reimbursement impacts as     specified in assignment. Develops an acceptable response and rationale for     it. Utilizes some examples.

Demonstrates     thorough knowledge of the business concepts involved in the issue, and     their implications. Thoroughly develops process differences and     reimbursement impacts as specified in assignment. Clearly answers the     questions and develops a very strong rationale. Introduces appropriate     examples.


30.0     %Integrates Information From Outside Resources into the Body of Paper

Does not use     references, examples, or explanations.

Provides some     supporting examples, but minimal explanations and no published references.

Supports main     points with examples and explanations.

Supports main     points with explanations and examples. Application and description is     direct, competent, and appropriate of the criteria.

Supports main     points with references, examples, and full explanations of how they apply.


20.0     %Organization and Effectiveness


7.0     %Thesis Development and Purpose

Paper lacks any     discernible overall purpose or organizing claim.

Thesis and/or main     claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main     claim are apparent and appropriate to purpose.

Thesis and/or main     claim are clear and forecast the development of the paper. It is     descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main     claim are comprehensive. The essence of the paper is contained within the     thesis. Thesis statement makes the purpose of the paper clear.


8.0     %Argument Logic and Construction

Statement of     purpose is not justified by the conclusion. The conclusion does not support     the claim made. Argument is incoherent and uses noncredible sources.

Sufficient     justification of claims is lacking. Argument lacks consistent unity. There     are obvious flaws in the logic. Some sources have questionable credibility.

Argument is     orderly but may have a few inconsistencies. The argument presents minimal     justification of claims. Argument logically, but not thoroughly, supports     the purpose. Sources used are credible. Introduction and conclusion bracket     the thesis.

Argument shows     logical progression. Techniques of argumentation are evident. There is a     smooth progression of claims from introduction to conclusion. Most sources     are authoritative.

Clear and     convincing argument presents a persuasive claim in a distinctive and     compelling manner. All sources are authoritative.


5.0     %Mechanics of Writing (includes spelling, punctuation, grammar, language     use)

Surface errors are     pervasive enough that they impede communication of meaning. Inappropriate     word choice and/or sentence construction are used.

Frequent and     repetitive mechanical errors distract the reader. Inconsistencies in     language choice, sentence structure, and/or word choice are present.

Some mechanical     errors or typos are present but are not overly distracting to the reader.     Correct sentence structure and audience-appropriate language are used.

Prose is largely     free of mechanical errors, although a few may be present. A variety of     sentence structures and effective figures of speech are used.

Writer is clearly     in command of standard, written, academic English.


10.0     %Format


5.0     %Paper Format (Use of appropriate style for the major and assignment)

Template is not     used appropriately, or documentation format is rarely followed correctly.

Appropriate     template is used, but some elements are missing or mistaken. A lack of     control with formatting is apparent.

Appropriate     template is used. Formatting is correct, although some minor errors may be     present.

Appropriate     template is fully used. There are virtually no errors in formatting style.

All format     elements are correct.


5.0     %Research Citations (In-text citations for paraphrasing and direct quotes,     and reference page listing and formatting are appropriate to assignment and     style)

No reference page     is included. No citations are used.

Reference page is     present. Citations are inconsistently used.

Reference page     lists sources used in the paper. Sources are appropriately documented,     although some errors may be present

Reference page is     inclusive of all cited sources. Documentation is appropriate and citation     style is usually correct.

In-text citations     and a reference page are complete and correct. The documentation of cited     sources is free of error.


100     %Total Weightage

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1. how healthcare charging and pricing processes are different from

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