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Lesson 10 Forum - Team 1

Lesson 10 Forum - Team 1

Q Review previous lessons and chapters, as well as internet resources to answer the following: 1. Explain the impact of inpatient and outpatient coding guidelines on reimbursement for both Medicare and Medicaid reimbursement. 2. Explain the basic steps in processing an insurance claim from the physician's office, to the insurance carrier, and after payment has been received. Any questions concerning this lesson or the textbook material should be posted to the link titled Ask Questions About L10 Here. I actively monitor that forum for student questions. Please do not request quiz answers or clarification to quiz answers until AFTER the quiz has closed, and you have had a chance to review the correct answers. If, after you have seen the correct answers you still have questions, you may post them to the link titled Ask Questions About L10 Here.

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The inpatient coding uses the ICD-10-CM and ICD-10-PCS codes to transcribe the details of a patient’s visit and stay while outpatient coding uses the ICD-10-CM and HCPCS level II codes to write down the healthcare services a patient has used. Medicaid reimbursements tend to be significantly lower as compared to Medicare for similar services for both inpatient and outpatient care. Despite their variations, Medicare and Medicaid both strive to embrace value based reimbursement. Medicaid is an assistance program and different states control its own Medicaid program. States have different regulations which further affect Medicaid reimbursements.