Unit IV Reimbursement Healthcare

Unit IV Reimbursement Healthcare:Instructions Reimbursement Healthcare reimbursement has greatly evolved since the time when medical services were often bartered for with items such as crops or livestock. Today, there are many ways that healthcare providers are reimbursed for their services, and methodologies are constantly changing. The purpose of this assignment is to explore the world of payment systems in health care.

• Compare and contrast four types of health insurance plans to include indemnity plans, health maintenance organization plans (HMOs), preferred provider organizations (PPOs), and point of service plans (POS).
• Differentiate between four reimbursement methodologies commonly used in health care today.
• Discuss the components of three government entitlement programs and who can qualify to be covered under them.
• Combine what you have learned in Unit III regarding coding with what you learned in this unit regarding reimbursement, and explain the importance of these entities being able to work together. Discuss AHIMA’s clinical documentation improvement (CDI) initiative and how it strives to improve the relationship between medical coding and reimbursement. Take advantage of sources outside your textbook for this topic. Make sure to cite properly using APA formatting.

Health insurance is a type of  that covers the whole or a part of the risk of a person incurring . As with other types of insurance is risk among many individuals. By estimating the overall risk of  and  expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or , to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or  entity.

According to the , health insurance is defined as “coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment