CAHIIM Competencies

Domain IV. Revenue Cycle

Subdomain IV.A. Revenue Cycle and Reimbursement

1. Manage the use of clinical data required by various payment and reimbursement systems

2. Take part in selection and development of applications and processes for chargemaster and claims management.

Student instructions

1. If you have questions about this activity, please contact your instructor for assistance.

2. You will review the chart of
Meridith Dewietz to complete this activity. Your instructor has provided you with a link to the
Creating a Claim activity. Click on
2:
Launch EHR to review the patient chart and begin this activity.

3. Refer to the patient chart and any suggested resources to complete this activity.

4. You will complete documentation in EHR Go as instructed below. When you complete this activity, you will download your Progress Report in EHR Go under
3: Download Work, save the Progress Report to your device, and then upload the Progress Report to your Learning Management System (LMS). 

1. Review the guide below found under Help/Guides on ehrgo.com:

·
EHR Go Guide to Claims and Ledgers

The activity

Meridith Dewietz was seen by in the Central Clinic today and diagnosed with Vitamin B12 deficiency anemia. She received a Vitamin B-12 injection during her visit.

A claim needs to be created and submitted to Medicare for the outpatient visit and the B-12 injection.

The claim must include the provider’s diagnosis of:
Vitamin B12 deficiency anemia, unspecified

The procedures and charges that need to be added to the claim are:

1.
Hospital outpatient clinic visit for assessment and management of a patient. Charge of $115

2.
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg. Charge of $85.

Post and save the claim.

Submit your work

You will complete documentation in EHR Go as instructed. Remember to save your work. When finished, click on the
Close Session button at the top right of the screen. Download your Progress Report in EHR Go under
3: Download Work, save the Progress Report to your device, and then upload the Progress Report to your Learning Management System (LMS). If you have any questions about submitting your work to your LMS, please contact your instructor.