In: Nursing
Briefly describe the regulatory and legislative requirements for billing covering a health care business.
If you have access to a workplace then, discuss the regulatory and legislative requirements for billing for your business?
Regulatory and legislative requirements for billing in
health care business:
Organizations are responsible for comply with
relevant legislation and regulatory requirements..organization need
to determine their legislative obligations..medical industry should
follow some standard and regulations from third-party billing
companies..these companies will not pay direct payment to
patient..so federal requirements under HIPAA Act palced standard
ensuring patient privacy..medical billing companies receive health
care claims by gathering information about patient entire service
provided..
Employees will work with HIPAA standards..medical
billing companies write HIPAA confidentiality while operating
policies and procedures for the safety..In health-care organization
patient those who can not pay their payment by insurance claims
medical billing comapanies can implement alternative means of
collecting money..
There are many regulations and legal obligations to comply with
managing the organization..business can be impact by statutes..most
business have attorneys on staff or retain firms to handle issues
surrounding the law..some rights and protection plan inthe health
insurance market place..each insurance company sign a contract
which regulates the practices of the physician and negotiates the
payment for their provider bills..this contract include the
important of billing rules provider's office has to be
follow..provider can not bill the patient for any amount over the
negotiated rate..it is called balance billing..and it is illegal as
per insurance company..medical billing fraud is a serious offense
taken by the federal government..
Besides many regulations and legislations governing medical
practices,doctors and their staffs must have some good business
knowledge..many of these are not from federal or locally
governed,but as a provider we have to treat the patient with good
quality..for a good business provide best care possible..