Health Information Management Coding And Billing In Reimbursement

INTRODUCTION


Health information management professionals play an important role in the Health Information Management (HIM) team in the area of coding management and reimbursement processes. The Centers for Medicare and Medicaid Services (CMS) introduced quality reporting systems to link financial rewards to the provision of quality healthcare.

In this task, you will describe various components of the coding and billing procedures and how errors may delay reimbursement or result in concerns of fraudulent practice. You will be required to discuss how several specific government directives have impacted healthcare organizations.

REQUIREMENTS

A. Analyze the quality reporting systems sponsored by Centers for Medicare and Medicaid Services (CMS) by doing the following:

1. Discuss the goals of the Merit-based Incentive Payment System (MIPS).

a. Describe the advantages and disadvantages of the MIPS.

2. Discuss the goals of the Value-Based Purchasing System (VBPS).

a. Describe the advantages and disadvantages of the VBPS.

3. Describe the role of Health Informatics and Information Management (HIIM) staff in participating in both MIPS and VBPS.

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