Explain the difference between Medicare and Medicaid billing.

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H07 Medical Coding I

Directions:  Be sure to make an electronic copy of your answer before submitting it to Ashworth College for grading.  Unless otherwise stated, answer in complete sentences, and be sure to use correct English spelling and grammar.  Sources must be cited in APA format.  Your response should be two (2) to four (4) pages in length; refer to the “Assignment Format” page for specific format requirements.

 

Lesson 1, 2, 3, and 4 of this course has covered a wide variety of topics. Thus far, you have learned a great deal of information on health insurance, medical contracts, HIPAA, physician and hospital medical billing, and Medicare and Medicaid.

 

For this writing assignment, please explain why the following course objectives are important for medical billers and coder to understand:

 

1.      Understand the history and impact of health insurance on health care reimbursement process and recognize various types of health insurance coverage.

 

2.      Identify the key elements of a managed care contract and identify the role HIPAA plays in the health care industry.

 

3.      Recognize and explain the different components of physician and hospital billing and differentiate between the two types of services.

 

4.      Explain the difference between Medicare and Medicaid billing.

 

 

Please include at least 3 scholarly articles within your response. Overall response will be formatted according to APA style and the total assignment should be between 2-4 pages not including title page and reference page.

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    h07eassignment4.docx

Analyze how performance and quality measures are aligned to the organizations mission, vision, strategic and operational plans.

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Note I have attached QI paper 1-3 with teachers comment on what to do for the following papers. Please read over and follow the instuctions below for this assignment base off of the 3 previous papers, please if you can not do assignment please do not accept assignment. It is important that I get a good grade.

 

 

Combine all four parts of the QI plan into one document, making sure to include instructor feedback. Organize the plan as you would present it to the organization’s board of directors for approval. Use the QI Plan Template as a guide.

In the QI Plan Template, complete the following:

  • Evaluate various data collection and display tools used in performance measurement.
  • Evaluate tools used to measure and report data.
  • Analyze various improvement methodologies for integrating quality improvement strategies into performance measurements.
  • Analyze the impact of information technology applications on performance measures.
  • Analyze the use of internal and external benchmarking and milestones in managing the utilization of quality indicators.
  • Evaluate criteria and tasks for developing quality improvement plans.
  • Analyze how performance and quality measures are aligned to the organizations mission, vision, strategic and operational plans.
  • Evaluate strategies for meeting regulatory and accreditation standards within health care organizations.
  • Evaluate measures used to monitor and revise quality program implementation.
  • Evaluate barriers that can interfere with the implementation of quality measures.
  • Evaluate strategies to ensure successful implementation of quality measures.

Write a 350- to 700-word executive summary related to your QI plan which includes an evaluation of the  following:

  • Evaluate the current state of QI at the organization, its organizational and operational QI structure, authority, mission, methodology, and tools used.
  • Recommend how the organization will achieve its objectives over the long term.
  • Evaluate challenges that may impact the future of health care quality improvement.
  • Evaluate effect of health care quality improvement on operational and financial performance.

Format your paper according to APA guidelines.

Cite 5 peer-reviewed, scholarly, or similar references to support your paper.

Click the Assignment Files tab to submit your QI Plan and your Executive Summary.

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    brenda_abayomi_qi_plan_part_one_1.doc

Should each department have a manager that reports to the same director?

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Discussion Question 1: Strategies to Minimize Risk

Risk can be minimized, but not eliminated. Give an example of a risk management solution being taken too far, and explain how you would judge how far is too far. Give another example of a situation where you must accept a certain level of risk because the risk cannot be controlled for any further.

 

Discussion Question 2: Risk Management and Organizational Structure

Organizations have tried several different approaches for creating an organizational structure that supports collaboration between the risk management and quality management departments. Which structure do you think would be most effective? Should the departments be combined? Should each department have a manager that reports to the same director? Is there a better alternative? Be sure to explain your answer.

 

How might your response plan for an epidemic such as the avian flu differ from your response plan for a natural disaster?

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Discussion Question 1: Risk Management and Natural Disasters

What type of disaster is your local hospital likely to face? Has this occurred in the past? Was the hospital prepared to respond appropriately? As a risk manager, what questions might you have about the hospital’s response plan?

 

Discussion Question 2: Risk Management and Epidemic

How might your response plan for an epidemic such as the avian flu differ from your response plan for a natural disaster? Are there resources to plan for that would be different? Are there resources that would be impacted regardless of the type of response plan that is needed?