Payment Differences Discussion 1

Discuss rationale as to why there are vast differences in payment for the same services (by CPT-treatment code) by various payer sources (e.g., private pay, grant, Medicare/Medicaid, traditional insurance like Blue Cross/Blue Shield, or managed care). How does this practice impact the profession and budgeting? Provide rationale for your choice. Your initial post should be at least 400 words.

Resources

Readings

1. Textbook:
Dropkin, M., Halpin, J., & LaTouche, B. (2007). The budget-building book for nonprofits (2nd ed.). Jossey-Bass.
Chapter 15: Estimating Income and Expenses

2. Article:
Final budget for fiscal year 2006 changes Medicaid and Medicare rules, cuts funds for mental health programs. (2006). Psychiatric Services, 57(3), 432-3.

3. Videos:
Roberts, P, [eHow]. (2008, November 1). Business Advice: How to Determine Profit [Video File]. Retrieved from https://youtu.be/4Z4HK2uctQE (Links to an external site.)

Hornor, J, [eHow]. (2009, May 26). Small Business Basics : How to Understand a Profit-Loss Statement [Video File]. Retrieved from https://youtu.be/1gI25MuIXkw  (Links to an external site.)

Recommended Readings
1. Website:
BlueCross BlueShield of Tennessee. (n.d.) Behavioral Health Specific Billing Guidelines. Retrieved from http://www.bcbst.com/providers/behavioral_health/billing_guidelines.pdf

 
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