Walden University – NURS 6565 Week 8: Coding and Billing Issues

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Walden University – NURS 6565 Week 8: Coding and Billing Issues

As you are now approaching graduation, your clinical exposure has allowed you to better understand the coding and billing process. An essential element in clinical practice will be reimbursement. All NPs must give due diligence and ensure all services provided are accurately coded and billed appropriately. Avoiding fraudulent billing is a key element to your success as an NP. As providers, we are ultimately responsible for billing that occurs with our assigned Medicare, Medicaid, and other third party reimbursement entities’ assigned numbers.

This week you will focus on understanding the differences in levels of billing and the importance of coding accurately. Additionally, billing barriers, which inhibit independent practice, and how this impacts your decision on relocating to an alternate state to have independent practice will be reviewed.

Learning Objectives

By the end of this week, students will:

• Analyze reimbursement issues
• Compare the impact of reimbursement issues between collaborative practice and independent practice
• Analyze ethical and legal implications of reimbursement issues

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Discussion: Reimbursement Issues for Nurse Practitioners

Understanding the complex process of accurate coding and billing is essential to a sustainable practice. As NPs, we are ultimately responsible for ensuring all coding and billing is accurate for each patient seen. For this Discussion, you will search the health care literature and summarize a peer-reviewed journal article published within the last five years.

To prepare:

• Select one of the following topics:
  • Applying for Medicare and Medicaid Provider Numbers
  • Application process for National Provider Identifier Number
  • Incident to billing
  • Coding-Evaluation & Management
  • Fraudulent billing
  • Billing Self-Pay patients
  • Managed Care Organizations
• Conduct a search and select a peer-reviewed journal article published within the last five years related to the topic you selected.

Note: For this Discussion, all students are to avoid all written work, which reviews or outlines coding and billing at previous or current worksites as well as previous or current practicum sites.

By Day 3

Post a brief summary of the article you selected. Include the key reimbursement issue addressed and how they would impact the NP in a collaborative practice versus and independent practice. Discuss an ethical or legal implication(s) associated with your article.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days by providing a comparison between the article you selected and the article that your colleague selected

More NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Walden Essays :

NURS 6565 Week 1: The Emerging Role of Nurse Practitioners in Diverse Clinical Settings

NURS 6565 Week 2: Consequences of Ethical Issues in Advanced Nursing Practice

NURS 6565 Week 3: Ongoing Performance Evaluation

NURS 6565 Week 4: Legal Issues (Negligence/Malpractice/Risk Management)

NURS 6565 Week 5: Interprofessional Practice

NURS 6565 Week 6: Certification, Licensure, and Scope of Practice

NURS 6565 Week 7: Prescriptive Authority and Drug Enforcement Administration Registration

NURS 6565 Week 8: Coding and Billing Issues

NURS 6565 Week 9: Professional Business Practice

NURS 6565 Week 10: Leadership Implications

NURS 6565 Week 11: Social Change Agents