Chapter 2, Problem 2.8.15C

With the use of Electronic Health Records most healthcare facilities and offices no longer submit a paper claim form instead of the fields in the EHR translate in the background to an electronic format of the CMS 1500 (physician claim) or a UB04 (hospital claim) form. However, it is still essential that you understand how to complete a claim form properly. In reviewing the different Blocks on the CMS 1500 form, choose a section of Blocks (as discussed in the unit) and in your own words: List the Block Numbers (i.e., Blocks 1-8), Describe what information goes into the Blocks Discuss any formatting requirements for the Blocks and what happens to a claim if the formatting is incorrect. In the second document above, CMS discusses Incomplete or Invalid Submissions. Explain how the Part A/Part B Medicare Administrative Contractors (MAC) handles these types of claims. CMS also discusses the difference between a “clean claim” and “other-than-clean claims.” Explain in your own words the…

HIPAA has made it illegal, under threat of penalty, for health care practitioners to disclose confidential health information about patients to unauthorized sources. Question: 1) Sharon, a second-year nursing student, is completing a surgical rotation in a community hospital. At the breakfast table, Sharon’s husband asks her to fin out what is wrong with one of his employees, who has been hospitalized for several days. He is interested in knowing when the man may be able to return to work. Is it ethical for Sharon to give her husband this information? Provide your reasoning.

Scenario:  Ms. Jones is a 50 y/o Asian female who has been seen by the provider.  Orders have been written for an 1800 calorie ADA diet, and she has been placed on two medications for hypertension.  She seems upset and does not think her blood pressure has been “high enough” for medication and wants to treat her blood pressure with herbal teas.            Describe in detail how you would demonstrate respect for this patient in spite of her gender, age, appearance, economic status, race and religious beliefs.