The life cycle of a medical claim can be very confusing for new staff. Each staff member plays a different part in contributing to the claim and pertinent documentation or submission of the claim. Nurses and clinical staff may not have as much to do with filling out claims forms as billers do, but they need to know what types of insurances require additional documentation and forms; front desk staff will need to know when to collect coinsurance and balance bills and when to ask for secondary insurances; coders will need to know any special coding requirements for secondary insurances. Billers will need to understand the entire cycle.
In this scenario, you are playing the role of a trainer and you will create a PowerPoint explaining the left cycle of a claim to new employees.
The first slide must include the life cycle of a claim overall. Create a SmartArt graphic to display the Life Cycle (DO NOT use an image found on the internet or in the content of the course).
How to create SmartArt graphic
In PowerPoint document, go to Insert tab
The remaining slides should explain the Life Cycle of a Claim
Establish Financial Responsibility
Patient Check-in & Check-out
Superbill (Encounter Form)
Prepare and Transmit the Claim
Monitor Payer Adjudication
Generate Patient Statement
Follow up Payments and Collections
The presentation should contain a minimum of 5 slides, not including Title and Reference Page
Write detailed speaker notes in the Notes section of each slide
Notes must be at least *** words for the total presentation
PLEASE DO NOT FORGET THE SPEAKER NOTES one of the most important requirements!