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Qaagi - Book of Why

Causes

Effects

that would begin the processto setyou up as a billing provider with Medicare , Medicaid and third - party payers

These ACA initiativesledto changes in Medicare , Medicaid , and private insurance

federal research dollars play in underpinning growth of health care costs with technologyresultingfrom relatively unconstrained third party payment -- insurance companies , Medicare and Medicaid

the standardssetforth for Medicare and Medicaid funded providers

quality and share ... the lower costsresultfrom better coordinating care for individuals enrolled in Medicare and Medicaid Medicare - Medicaid enrollees

This focushas resultedin an unprecedented spike in the number of Medicare , Medicaid and third party payor audits

a healthcaresettingto include Medicare , Medicaid and third party billing

state and federal lawmakers(passive) set byMedicaid and Medicare policies

the reimbursement levels for servicessetsthe reimbursement levels for services

telehealth reimbursement guidelineshave createdtelehealth reimbursement guidelines

large part(passive) led bylarge part

high health care pricescausinghigh health care prices

inelastic demandcreatesinelastic demand

Speed and extent of generic substitution(passive) caused bySpeed and extent of generic substitution

complex billing and coding requirements(passive) set ... bycomplex billing and coding requirements

rules(passive) set byrules

a remittance processing unit to insure proper contractual allowances at time of posting Consulted in revenue cycleCreateda remittance processing unit to insure proper contractual allowances at time of posting Consulted in revenue cycle

complex Urology billing and coding requirements(passive) set ... bycomplex Urology billing and coding requirements

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