Question
In your current role as the reimbursement analyst for a large provider group, you are responsible for ensuring the group receives payments for services rendered
In your current role as the reimbursement analyst for a large provider group, you are responsible for ensuring the group receives payments for services rendered in accordance with established payor contracts. A new staff member has been hired to work in the billing office and unfortunately has no prior experience working in a provider office.
For your initial response to this discussion, compare and contrast the fee-for-service and episode of care reimbursement methodologies.
In your response, include the following:
- A description of each methodology.
- An explanation of the benefits and drawbacks of each.
Finally, identify one payment method within a methodology and describe how the provider would be reimbursed under the payment model. Examples include fee-for-service and self-pay.
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