1st page- Cover page

2nd page- Abstract (include what is the purpose of this project) 

3rd page- Answering the following questions:

Describe the differences among a sole proprietorship, partnership, and corporation.

1.    Identify the major disadvantage of a sole proprietorship or a partnership.

2.    How does a corporation differ from a partnership?

3. What conflicts exist when a MCO provides bonuses to physicians for providing fewer tests?

4th page- References

APA citation is required.

Chapter Overview

Chapter 1 covers a lot of ground and sets the stage for the rest of the text. The premise of this text is that the health care industry is a big business and what medical office professionals do on the frontline matters. Students’ understanding of the laws and issues related to working in a medical office will help them protect patients, their employers, and themselves from unnecessary risks.

The scope of practice is a foundational issue discussed in Chapter 1. Because both state and federal law regulate the practice of medicine, it is necessary for students to be aware that there is an assortment of statutes and regulations that define the procedures they will be permitted to perform. This chapter also features discussion of the standard of care for medical professionals and laypersons and what it means to be a medical assistant.

Technical aspects of the law are useful for medical office professionals so they can understand the business aspects of working in a medical office. That is why this chapter includes discussion of the several types of legal entities, such as corporations, limited liability companies, and sole proprietorships, among others.

Another foundational issue is managed care organizations (MCOs), including HMOs, PPOs, and ACOs. It will be necessary for students to be familiar with the many facets of MCOs, including the focused objectives of reducing costs and delivering quality health care.

And, finally, this chapter features a discussion about telemedicine as an alternative health care delivery system that has become increasingly commonplace. The use of telemedicine is still in its infancy, but it has the potential to dramatically change the practice of medicine. Your students will learn that telemedicine is one more example of how health care has become big business.

Assignment 1: Evaluation and Management (E/M)

Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.

For this Assignment, you will review evaluation and management (E/M) documentation for a patient and perform a crosswalk of codes from DSM-5 to ICD-10. 

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To Prepare

• Review this week’s Learning Resources on coding, billing, reimbursement.
• Review the E/M patient case scenario provided.

The Assignment

• Assign DSM-5 and ICD-10 codes to services based upon the patient case scenario. 

Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.

• Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding.
• Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
• Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.