Question 1.

In your post, compare the characteristics and claims filing processes of private and public payers. What type of ethical issues could arise with personnel during the claims filing processes?

Imagine yourself sitting around a conference table with your instructor and classmates. This discussion topic will be similar. It is a place in which you can have lively conversations with your instructor and peers on the course content. These discussions will help you internalize the course content and become more comfortable with it. You should provide thoughtful responses using the course content to support your statements. Although these discussions are more informal, please be aware of how you are presenting yourself professionally. Please do not use slang and be aware of your spelling.

What to Submit

Write an initial post (ideally 1 to 2 paragraphs) and reply to at least two posts during the week outside of your initial post thread.

Question 2.

Week 3 Discussion Board

Post on three separate days to the discussion board. Make an initial post that answers all questions, and then make two more posts on separate days to two different classmates. It is important to review the Discussion Board rubric to understand the expectations and grading criteria. Include a citation for your initial post and at least one response post using APA 7th edition format.

To begin discussing in this forum, click the forum title. Then, click Create Thread on the Action Bar to post your initial reply. To reply to a fellow participant, click the title of the initial post, then click Reply.

NOTE:  This week’s discussion is worth 10% of your total grade.)

Topics: Coding and CMS Reimbursement Methodologies

1.  Chapters 6, 7, 8 discuss 3 different coding systems.

Define the following coding sets:

1. ICD -10-CM
2. ICD-10-PCS
3. CPT
4. HCPCs Level II

2.  Chapter 9 discusses CMS’s reimbursement systems.  Read and discuss the following:

• What is a payment system? Define Prospective cost-based rates and Prospective price-based rates.
• How does CMS reimburse services performed in these three locations? Discuss the payment system for each.
• Hospital Inpatient (DRGs)
• Hospital Outpatient (APCs)
• Physician Services (RBRVS)
• What is a Medicare nonPAR physician?  How much can they charge and how is the fee schedule different for nonPar physicians?

Question 3.

In this discussion board, you will compare healthcare reimbursement methodologies in Saudi Arabia with the United States. Research and evaluate the need for more public and private funding of healthcare in Saudi Arabia. Your response should address the following: Description of current reimbursement formats in Saudi Arabia and the United States. Pros and