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In: Nursing

Briefly describe the regulatory and legislative requirements for billing covering a health care business. If you...

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?

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Expert Solution

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..


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