Scenario: The physician you work for is new

Scenario: The physician you work for is new. For the first time he/she has a single provider practice. The doctor is concerned that the reimbursement for the office is not the same as fellow physicians

Scenario: The physician you work for is new
AHS1650-6 Achieving Maximum Reimbursement

Competency Checklist

Name: __________________ Date: ______ Score: _

AHS1650-6 – Work with Physician to Achieve Maximum Reimbursement

Objectives: Assist the physician to achieve maximum reimbursement through proper documentation of procedures and diagnostic coding and proper utilization of the E & M codes.

Scenario: The physician you work for is new. For the first time he/she has a single provider practice. The doctor is concerned that the reimbursement for the office is not the same as fellow physicians with the same patient load, specialty and demographics. Because you helped reduce cost through better inventory control and management of the office, the doctor wants your help in determining how to increase revenue through reimbursements.

Assignment: Using tactful language, write a summary paper (one page/500 words) recommending how the provider and members of the practice can improve the reimbursement rate for the work being performed. At a minimum, you must address proper charting and documentation, scheduling, diagnosis codes, procedure codes, evaluation and management codes to include counseling on preventive medicine, and completion of CMS 1500 and insurance claim forms.

Scoring System:
Each requirement of the procedures for a competency will carry an assigned point value of ten (10).
The point value will reflect how well you covered the topic: ten (10) meaning you covered the topic completely to zero (0) meaning you did not cover it at
Total score will determine passing or failing following the policy for grading and scoring
Your paper should be a minimum of one page or 500 words.
MA Students are required to pass all competencies with a minimum score of 75%
Work product: The final paper will be attached to the competency. Your assignment will be submitted to the instructor through Moodle.

Element Possible Attempt 1 2 3

  1. Charting 10
  2. Scheduling 10
  3. Diagnosis Codes 10
  4. Procedure Codes 10
  5. Evaluation and Management Codes 10
  6. CMS 1500 and Insurance Forms 10
  7. Other 10
    Possible Total 70 /70 / /70
    Comments:Click or tap here to enter text.

Evaluator Signature: _ Date Complete: ____


IX.A.1 Utilize tactful communication skills with medical providers to ensure accurate code selection

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