Interview with Health care Coder/Biller - Assignment Example

Payment is due for each of the specific service offered. Here, the second party charges for every service rendered, and the insurance company pays the fees for each covered service. When there is typically less relationship between the real cost and the charge of providing a service, the health care organization bills for each service given on a claim that lists the fees for each service. The claim is sent to the third party payer who pays the claim. Episode of care reimbursement is where the providers receive a single lump sum for all the services provided related to the disease.

Here, the unit of payment is the episode and not the individual’s health service. Respondent: The prices of drugs do not go down as one would expect in the other fields. Also, the federal government cannot negotiate lower prices on the commodities it buys. The unique aspects of individuals body, makes it difficult to determine what procedures are required over a period of illness, or how much it will cost. The charging and pricing process for healthcare is different from other industries because health care costs in a number of cases have to be subsidized by a third party.

Government and private insurers help provide coverage for federal patients. On the other hand, when private insurers are involved in public hospitals, in large numbers, they may interfere with the hospitals as they may increase private insurance premiums in public hospitals. This affects the patients and the hospital negatively, because patients start paying more for basic services from the hospital. Respondent: In order for the health care system to secure the benefits of personalized medicine, it must present an opportunity for the full reimbursements for the latest technology.

The cost of these new products is greater than the ones they are replacing and may offer better results for a smaller number of patients. Both the