Incorrect coding can happen for a variety of reasons, including data entry error
Incorrect coding can happen for a variety of reasons, including data entry errors, misinterpretation of regulations, and internal control and system problems. In the case of PPS transfer cases, incorrect coding of patient status as discharged (rather than transferred) may result in overpayment. The healthcare manager must ensure that employees are aware of and understand the regulations and know how to follow them. The manager must also have systems in place to detect potential errors.
Case Study Materials:
United States Department of Health and Human Services. (2003). Compliance with New York State Medicaid inpatient prospective payment system transfer regulations [Government report]. Retrieved from http://oig.hhs.gov/oas/reports/region2/20201004.pdf
Harrington, K. (2016). Healthcare finance and the mechanics of insurance and reimbursement. Burlington, MA: Jones & Bartlett Learning.
After reading the case study please develop a one-page draft to the following question. Make sure you include the introduction before answering the question below.
1) What do you think of the recommendations presented in the report?
Remember to only use the 2 references provided, not other sources allowed.