Cycle of Claim

Cycle of Claim

Instructions

The life cycle of a medical claim can be very confusing for new staff. Each staff member plays a different part in contributing to the claim and pertinent documentation or submission of the claim. Nurses and clinical staff may not have as much to do with filling out claims forms as billers do, but they need to know what types of insurances require additional documentation and forms; front desk staff will need to know when to collect coinsurance and balance bills and when to ask for secondary insurances; coders will need to know any special coding requirements for secondary insurances. Billers will need to understand the entire cycle.

In this scenario, you are playing the role of a trainer and you will create a PowerPoint explaining the left cycle of a claim to new employees.

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Cycle of Claim

Cycle of Claim

  • The first slide must include the life cycle of a claim overall. Create a SmartArt graphic to display the Life Cycle (DO NOT use an image found on the internet or in the content of the course).
    • How to create SmartArt graphic
      • In PowerPoint document, go to Insert tab
      • Choose SmartArt
      • Choose Cycle
  • The remaining slides should explain the Life Cycle of a Claim
    • Patient Pre-Registration
    • Establish Financial Responsibility
    • Patient Check-in & Check-out
    • Superbill (Encounter Form)
    • Prepare and Transmit the Claim
    • Monitor Payer Adjudication
    • Generate Patient Statement
    • Follow up Payments and Collections

Cycle of Claim

Requirements:

  • The presentation should contain a minimum of 5 slides, not including Title and Reference Page,
  • Select one of the following options for your presentation,

1.  Narrated and converted to a video

  • The completed video must be a minimum of 5-6 minutes in length,
  • Upload the video to YouTube and submit the URL for your video,
  • How to create a video in PowerPoint and upload to YouTube,

2.  Record Audio Narration in PowerPoint

  • Audio narration must be a minimum of 5-6 minutes in length,
  • You must have narration for each slide,
  • How to Record Audio (start watching at 00:27-2:00),

3. Write detailed speaker notes in the Notes section of each slide,

You must cite your references using correct APA formatting on a References slide.

Please be cautioned that any material used in the assignment directly from the internet (copy and paste) will be given a zero-based on Herzing University Ethics Policy (Plagiarism). All information not your own must be given appropriate APA citation reference.