Using your textbook and the Center for Medicare and Medicaid Services website, explain how the appeals...

Using your textbook and the Center for Medicare and Medicaid Services website, explain how the appeals process works when disputing a claim. Make sure these sources are cited at the end of the paper using APA style. Discuss two ways the Center of Medicare and Medicaid Website is beneficial for the public, and two ways it might be confusing to the public.

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Expert Solution

1.The center for Medicare and Medicaid services is a federal agency under the US department of health and human services. It provides Medicare program to public in association with state government to administer Medicaid . Earlier it was known as health care financing administration .

Original Medicare service are of two types :-

- part A ( Inpatient service are provided like surgery ,hospice care , ICU care)

- part B (Outpatient services are provided like OPD's , ambulance service , durable medical equipment services etc) .

- part C include vision , hearing benefits.

-part D include drug prescription benefits

3. Two ways it is beneficial to public are :-

- low monthly premium

- extra coverage like vision , hearing ,dental and health and wellness program .

Two ways it might be confusing to the publisher are :-

- seamless conversion

- part D has inequitable drug prescription that keeps on renewing ever year and causes confusion with pharmacies involved in the plan and the money to be given

The appeal process workflow chart :-

reference -U S Department of Health and Human services

-http://www.hhs .gov

Nightingale answered 1 year ago

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