Select a provider or health care facility coder/biller to interview and review the process they go through to satisfy reimbursement requirements for billing purposes.
Write a paper of 750-1,000 words that describes the processes that are utilized in producing a final bill. Include in the paper:
How health care charging and pricing processes are different from those in other industries.
How private and government insurers and payers impact actual reimbursement.
Cite a minimum of three references to support your rationale.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Less Than Satisfactory
40.0 %Essay Report on Interview with a Health Care Coder/Biller with the Difference Between Charging/Pricing Processes in Health Care vs. Other Industries, and Impact of Government and Private Insurers and Payers on Actual Reimbursement
Does not demonstrate an understanding of the business concepts involved in the issue, including the implications. Does not address process differences and reimbursement impacts as specified in assignment. Does not demonstrate critical thinking and analysis of the situation, and does not develop effective answers to the questions, with rationale.
Demonstrates only minimal understanding of the business concepts involved in the issue. Only minimally addresses process differences and reimbursement impacts as specified in assignment. Demonstrates only minimal abilities for critical thinking and analysis of the case study, and develops weak answers to the questions, with minimal rationale
Demonstrates knowledge of the business concepts involved in the issue, but has some slight misunderstanding of the implications. Satisfactorily addresses process differences and reimbursement impacts as specified in assignment. Provides a basic idea of critical thinking and analysis for the questions, answers, and rationale. Does not include examples or descriptions.
Demonstrates acceptable knowledge of the business concepts involved in the issue. Satisfactorily develops process differences and reimbursement impacts as specified in assignment. Develops an acceptable response and rationale for it. Utilizes some examples.
Demonstrates thorough knowledge of the business concepts involved in the issue, and their implications. Thoroughly develops process differences and reimbursement impacts as specified in assignment. Clearly answers the questions and develops a very strong rationale. Introduces appropriate examples.
30.0 %Integrates Information From Outside Resources into the Body of Paper
Does not use references, examples, or explanations.
Provides some supporting examples, but minimal explanations and no published references.
Supports main points with examples and explanations.
Supports main points with explanations and examples. Application and description is direct, competent, and appropriate of the criteria.
Supports main points with references, examples, and full explanations of how they apply.
20.0 %Organization and Effectiveness
7.0 %Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.
8.0 %Argument Logic and Construction
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice, sentence structure, and/or word choice are present.
Some mechanical errors or typos are present but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
5.0 %Paper Format (Use of appropriate style for the major and assignment)
Template is not used appropriately, or documentation format is rarely followed correctly.
Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.
Appropriate template is used. Formatting is correct, although some minor errors may be present.
Appropriate template is fully used. There are virtually no errors in formatting style.
All format elements are correct.
5.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting are appropriate to assignment and style)
No reference page is included. No citations are used.
Reference page is present. Citations are inconsistently used.
Reference page lists sources used in the paper. Sources are appropriately documented, although some errors may be present