Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle

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In this assignment, you will demonstrate your mastery of the following course outcomes:
 Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle   Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements   Analyze organizational strategies for negotiating healthcare contracts with managed care organizations   Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations   Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives

Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There are several ways to accomplish this. Choose one of the following:
 If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses.  Conduct research through articles or get information from professional organizations.
Below is an example of how to begin framing your analysis.
A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what happens in an emergency area. The patient could be asked to change into a hospital gown (think about the costs of the gown and other supplies provided). If the patient is displaying signs of vomiting, plastic bags will be provided and possibly antinausea medication. Lab work and possibly x-rays would be done. The patient could be sent to surgery, sent home, or admitted as an inpatient. If he or she is admitted as an inpatient, meals will be provided and more tests will be ordered by the physician—again, more costs and charges for the patient bill. Throughout the course, you will be gathering additional information through your readings and supplemental materials to help you write your white paper.
When drafting this white paper, bear in mind that portions of your audience may have no healthcare reimbursement experience, while others may have been given only a brief overview of reimbursement. The goal of this guide is to provide your readers with a thorough understanding of the importance of their departments and thus their impact on reimbursement. Be respectful of individual positions and give equal consideration to patient care and the business aspects of healthcare. Consider written communication skills, visual aids, and the feasibility to translate this written guide into verbal training.
Specifically, the following critical elements must be addressed:
I. Reimbursement and the Revenue Cycle  A. Describe what reimbursement means to this specific healthcare organization. What would happen if services were provided to patients but no payments were received for these services? What specific data would you review in the reimbursement area to know whether changes were necessary? B. Illustrate the revenue cycle using a flowchart tool. Take the patient through the cycle from the initial point of contact through the care and ending at the point where the payment is collected.
C. Prioritize the departments at this specific healthcare organization in order of their importance to the revenue cycle. Support your ordering of the departments with evidence.
II. Departmental Impact on Reimbursement A. Describe the impact of the departments at this healthcare organization that utilize reimbursement data. What type of audit would be necessary to determine whether the reimbursement impact is reached fully by these departments? How could the impact of these departments on pay-forperformance incentives be measured? B. Assess the activities within each department at this healthcare organization for how they may impact reimbursement. C. Identify the responsible department for ensuring compliance with billing and coding policies. How does this affect the department’s impact on reimbursement at this healthcare organization?
III. Billing and Reimbursement A. Analyze the collection of data by patient access personnel and its importance to the billing and collection process. Be sure to address the importance of exceptional customer service. B. Analyze how third-party policies would be used when developing billing guidelines for patient financial services (PFS) personnel and administration when determining the payer mix for maximum reimbursement. C. Organize the key areas of review in order of importance for timeliness and maximization of reimbursement from third-party payers. Explain your rationale on the order. D. Describe a way to structure your follow-up staff in terms of effectiveness. How can you ensure that this structure will be effective? E. Develop a plan for periodic review of procedures to ensure compliance. Include explicit steps for this plan and the feasibility of enacting this plan within this organization.
IV. Marketing and Reimbursement A. Analyze the strategies used to negotiate new managed care contracts. Support your analysis with research. B. Communicate the important role that each individual within this healthcare organization plays with regard to managed care contracts. Be sure to include the different individuals within the healthcare organization. C. Explain how new managed care contracts impact reimbursement for the healthcare organization. Support your explanation with concrete evidence or research. D. Discuss the resources needed to ensure billing and coding compliance with regulations and ethical standards. What would happen if these resources were not obtained? Describe the consequences of noncompliance with regulations and ethical standards.

Expand the discussion to focus strategies you apply to deal with stress and the stress that patients and families deal with in a hospital setting. How can you assist them? Bring pertinent personal experiences into the discussion, if any.

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Personal beliefs and values guide a nurse’s practice and attitude. Patient situations occur that may challenge your beliefs and values.

Describe one experience in which your patient’s beliefs about his or her medical care differed from your beliefs.

  • Describe the differences between your beliefs and those of the patient.
  • Analyze and describe feelings this situation brought forth.
  • Evaluate strategies for dealing with this situation in a nonjudgmental way.

 

Question 2

Complete the following tasks:

  • Complete the life-changes questionnaire in your course textbook on pages 248 and explain your life-stress index and how your level of stress impacts you.
  • Expand the discussion to focus strategies you apply to deal with stress and the stress that patients and families deal with in a hospital setting. How can you assist them? Bring pertinent personal experiences into the discussion, if any.
  • Explain how those instances of stress affect behavior. How does understanding stress and its effects change your view of patient behavior?

1.    Analyze the components of the nursing management process within a clinical context.

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Module II

Leadership, Followership, Management

Learning Objectives

Module II concentrates on the following course outcomes—

1.    Analyze the components of the nursing management process within a clinical context.

The management process of planning, organizing, directing, controlling, and staffing is introduced. The process is used by leaders and managers in the performance of positions. The process is also used as the guiding framework for this course.

2.    Critique the professional nurse’s leadership role in guiding a diverse care team.

The nurse’s leadership role is described and explored. The emphasis is on the leadership role of the professional staff nurse as well as other levels of nursing leadership in an organization.

3.    Integrate management concepts into the competent provision of client care.

The nurse’s management role is also described in the module. The differentiation between leadership and management tasks and behaviors is explored. The emphasis is on the leadership and management role of the professional staff nurse as well as other levels of nursing management in an organization.

Reading Assignment

Sullivan: Chapters 4, 7, 17

Overview

Leading, managing and following are integral parts of professional practice. Constructive behaviors associated with these concepts will influence patient care and organizational outcomes, regardless of titles. Leadership and management behaviors can be learned. It is important to recognize that leadership and management are two different concepts. One can be a manager and not be a leader, and vice versa. Leadership behaviors used by managers greatly affect followers and may be positive or negative. Both leaders and managers use power and influence to accomplish organizational goals. Dynamic leaders are those who mentor, coach, respect and positively contribute to the development of others. Think about people that you have known who are positive leaders, what characteristics and behaviors do they exhibit to influence others. What types of communication styles do leaders typically use?

There are a number of theories of leadership, managementand motivation that may be applied within an organization. Some of the common leadership theories include: Transformational Theory, Situational Contingency Theory, and motivation theories such as Herzberg’s, Maslow’s and Expectancy and Goal Setting Theory. In organizational behavior, there has been much research over the years in relation to what motivates people with the conclusion that there are two broad categories of motivation: 1) content and 2) process. Content theories are referred to as “needs theories” as they explain the specific factors that motivate people. These theories give insight into the question of “what drives people.” Process theories are also called cognitive theories and focus on what cognitive thinking motivates or drives the individual to initiate, redirect or halt behavior (Borkowski, 2005). Motivation is about providing an organization and culture that satisfies both of the employees intrinsic and extrinsic needs.

There are a number of concepts available related to leadership, management and organizational behavior. Power, one such concept, is used in the organization to influence the behavior of others. Yoder-Wise describe five behaviors that nurses use in relation to power related to political and professional practice. These include: 1) apathy, buy-in, self-interest, political sophistication and leading the way. These power related behaviors can positively or negatively influence organizational behavior. Empowerment has received much recognition in the healthcare community in the past two decades. It relates to personal and professional power or control for practice. It is seen in conjunction with autonomy, shared leadership, decentralized organizations and those with Magnet status.

Clinical leadership offers many challenges; one is to recognize the effect of personal and professional needs that motivate staff to perform job duties and reach desired outcomes. Finding out what motivates staff fosters empowerment through approval, satisfaction, accomplishment, and self-esteem, which fuel individual motivation. Individuals bring to the workplace different needs and goals, the type and intensity of motivators vary among employees. Motivated employees are more likely to be productive than are non-motivated workers. This is one reason that motivation is an important aspect of enhancing employee performance. It is imperative with the constant change within the health care settings with cost containment, cutbacks and reimbursement. As a leader much of the success in directing or delegating to staff less qualified than will depend on people-management skills—your ability to motivate those around you. The most successful motivators often become the most successful leaders. They are the leaders who cause things to happen with their ability to influence others. Methods used to motivate others are to establish credibility. Follow up on problems and when you keep all promises your credibility becomes firmly established. Be a role model by setting the tone and pace for your team. You set the standard for ethical behavior and support the view of what is important. Take an interest in others, as one of the greatest motivators is caring. Make sure it is genuine interest. Overzealous or insincere praise is as meaningless as no praise at all. Reward positive behaviors, which only reinforce the behavior and set the example for others. Share decision making with the staff. Staffs perform better when they feel they are contributing to a team effort, making a difference and work better when they are included. Offer constructive criticism. Sometimes it is necessary to offer constructive criticism to improve performance. Criticism should be directed toward the observed behavior and not toward the individual and should be in private.

Classic management functions include: planning, organizing, directing, controlling and staffing. Within these four broad categories are more specific management and organizational concepts as are pointed out in the Module I Power Point presentation. It is important to know the four broad categories of management. Contemporary management is outcome oriented and supports the missions and values of an organization. Key management functions to be familiar with include recognition, delegation, decision making, reporting, budgeting, problem solving and critical thinking. Each of these activities will be addressed in this course.

Assignment questions: Post answers in Forums Module II. See calendar for due date.

1. Select one of the leadership, management or motivational theories from the readings and discuss how you think it applies within the organization.

2. Describe your own leadership behaviors. Discuss leadership behaviors that you most admire.

3. Discuss leadership traits that you would like to acquire.

4. What are differences in management roles and leadership roles differ?

5. Discuss various types of power seen in an organization and which are advantageous and which are detrimental.

 

Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations.

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Consider the following scenarios:

Scenario 1: Jennifer is a 2­year­old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days.  Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2­year­old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

 

Scenario 2: Jack is a 27­year­old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

 

Scenario 3: Martha is a 65­year­old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with

hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87­year­old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To prepare:

Review the three scenarios, as well as Chapter 6 in the Huether and McCance text. Identify the pathophysiology of the disorders presented in the scenarios, including their associated alterations. Consider the adaptive responses to the alterations. Review the “Mind Maps—Dementia, Endocarditis, and Gastro­oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 

To complete:

Write a 2­ to 3­page paper that addresses the following:

Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations. Construct a mind map of your selected disorder. Include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

 

Identify your population, and explain why this specific population within your community qualifies as at-risk.

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Culturally Competent Planning

 

For this assignment, select a vulnerable population in your community and explain how health care can be affected by cultural, ethnic, and social backgrounds. Building on the skills that you practiced in your Unit 6 assignment, create a plan to promote health and wellness within your chosen population, using (and correctly citing) information from this week’s study activities and any additional resources that you find on your own as you research your chosen population. Paper length: 6-7 pages.

 

For the population, you can use Denver, and what risks, at-risk population we have. Inflation of the housing market, and not being compensated for the cost of living is just an example…but you’ll have to do a little research for our at-risk populations.

 

For your assignment:

  1. Identify your population, and explain why this specific population within your community qualifies as at-risk.
  2. Identify health concerns for this at-risk population.
  3. Identify existing resources in your community that serve and promote health for this specific underserved, at-risk population.
  4. Identify high-quality electronic sources of health care information to address the needs of your chosen population.
  5. Create an evidence-based plan to promote health and wellness in this at-risk population.
  6. Explain how culture, ethnicity, and social background may affect your health care plan and what strategies you would put in place to address these concerns.
  7. Follow the guidelines of APA writing style, using correct grammar, punctuation, and mechanics. Evaluate your work by reviewing it for clarity and logic.
  8. Correctly format citations (in-text and in your Reference list) using APA style.

9.Culturally Competent Planning Scoring Guide

Culturally Competent Planning Scoring Guide Grading Rubric
Criteria Non-performance Basic Proficient Distinguished
Explain why a specific population in your community qualifies as at-risk.
13% 		Does not explain why a specific population in your community qualifies as at-risk. Partially explains why a specific population in your community qualifies as at-risk. Explains why a specific population in your community qualifies as at-risk population. Explains why a specific population in your community qualifies as at-risk, including insightful rationale.
Identify health concerns for an at-risk population.
13% 		Does not identify health concerns for an at-risk population. Identifies health concerns for an at-risk population, but explores or supports at a minimal level. Identifies health concerns for an at-risk population. Identifies health concerns for an at-risk population and supports the existence of the risk with data from multiple sources.
Identify existing resources in your community that serve an at-risk population.
13% 		Does not identify existing resources in your community that serve an at-risk population. Identifies existing resources in your community that serve an at-risk population, but explores or supports at a minimal level. Identifies existing resources in your community that serve an at-risk population. Identifies existing resources in your community that serve an at-risk population, and explores the contribution made to the community by those resources.
Identify high-quality electronic sources of health care information to address the needs of a diverse population.
12% 		Does not identify high-quality electronic sources of health care information to address the needs of a specific population. Identifies electronic sources of health care information, but sources are only marginally appropriate for the needs of the specific population. Identifies high-quality electronic sources of health care information to address the needs of the specific population. Identifies high-quality electronic sources of health care information to address the needs of the specific population, and explains the strengths and weaknesses of each source.
Create an evidence-based plan to promote health and wellness in an at-risk population.
17% 		Does not create an evidence-based plan to promote health and wellness in an at-risk population. Creates a plan to promote health and wellness in an at-risk population, but plan is supported by minimal evidence. Creates an evidence-based plan to promote health and wellness in an at-risk population. Creates an evidence-based plan to promote health and wellness in an at-risk population, using multiple sources of evidence that reflect a high level of support for the plan.
Create strategies to support plan implementation, addressing characteristics of culture, ethnicity, and social background that could affect the plan.
17% 		Does not create strategies to support plan implementation. Creates some strategies to support plan implementation, but does not sufficiently address characteristics of culture, ethnicity, and social background that could affect the plan. Creates strategies to support plan implementation, addressing characteristics of culture, ethnicity, and social background that could affect the plan. Creates strategies to support plan implementation, addressing characteristics of culture, ethnicity, and social background that could affect the plan, and expanding on and exploring the strategies and characteristics with details and examples.
Apply APA writing style to write clearly and logically, with correct use of grammar, punctuation, and mechanics.
10% 		Does not apply APA writing style to write clearly and logically, with correct use of formatting, grammar, punctuation, and mechanics. Partially applies APA writing style to write clearly and logically, with correct use of formatting, grammar, punctuation, and mechanics. Applies APA writing style to write clearly and logically, with correct use of formatting, grammar, punctuation, and mechanics. Applies APA writing style to write clearly and logically, with correct use of formatting, grammar, punctuation, and mechanics, with no errors.
Correctly format citations using APA style.
5% 		Does not correctly format citations using APA style. Partially formats citations using APA style. Correctly formats citations using APA style. Correctly formats citations using APA style, with no errors.

 

Please make sure to correctly site the reference page with the full reference.

Biological basis. Describe the technology. Discuss what it accomplishes. Elaborate on the scientific principles that make this technology possible

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Select one (1) of the following biotechnology topics to write about:

· Genetically modified crop plants

· Genetically modified microorganisms

· Genetically modified animals

· Personal genomics and / or personalized medicine for humans

· Gene therapy

Write a four to six (4 to 6) page paper on your chosen topic.  Organize your paper into sections corresponding to the following requirements:

1. Biological basis. Describe the technology. Discuss what it accomplishes. Elaborate on the scientific principles that make this technology possible. Your goal in this section of the paper is to show the instructor that you understand the underlying science behind the technology. Describe how exactly the technology works. Discuss the biological principles that underlie this technology.

2. Social and ethical implications. Without disclosing your personal view about this technology, provide an analysis of its social and ethical implications. State the ethical concerns apparent in the use of this technology. Discuss the benefits and risks. Your goal in this section is to look at all sides of the issue. In the next section, you will give your opinion.

3. Personal viewpoint. In the previous section, your goal was to be as objective as possible, to look at all sides of the issues. In this section, your goals are to give a personal opinion about the technology and provide a justification of that opinion.

4. Use at least three (3) quality resources in this assignment, in addition to the course text. Note: Wikipedia and similar Websites do not qualify as quality resources. The body of the paper must have in-text citations that correspond to the references. Integrate all sources into your paper using proper techniques of quoting, paraphrasing and summarizing, along with proper use of in-text citations to credit your sources.

Collaboration and partnership among agencies is important when creating community health promotion and education programs.

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Biology homework help

Collaboration and partnership among agencies is important when creating community health promotion and education programs.

For your health promotion program, you have decided to establish a community coalition to address continuing needs and issues relating to your specific health issue. Develop and name your coalition and identify who in the community, other than health educators, you will want to be part of this coalition. Remember that a coalition’s membership should not only reflect the demographic nature of the community, but the needs within the community. Choose 5 partnerships to engaged and explain why you would invite each of these people/organizations to be a part of the coalition.

Present your assignment as a 2-3 page Microsoft Word document. Please include APA-style formatted references in the body of the paper and as a reference list. Upload the document to appropriate Unit dropbox by the due date.

assignment 2

World AIDS Day

TO: Agency Health Education and Health Promotion Personnel

FROM: The Director

RE: World AIDS Day

As you are aware, World AIDS Day is quickly approaching. I would like your staff to send me a listing of ideas and methods our department could use to promote this international event. With each method please provide the funding needed to successfully complete the project.

Research potential funding opportunities by visiting – Partners in Information Access for the Public Health Workforce – http://phpartners.org/grants.html

Thank you for your attention to this matter.

discussion

International Health Education

Select a country you do not live in to research its culture, history, and common health-related problems. You can use a variety of literature to develop your answer.

State the health issue and identify the institution responsible for health promotion as well as the forms of media or printed materials implemented to increase health awareness (locally and globally).

In your opinion, what are the major challenges public health organizations face when addressing global health concerns?

thoroughly research a health care profession using the Internet and other library resources. Learn about the education, licensing, credentialing, professional organization, working conditions, and other aspects of the profession.

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thoroughly research a health care profession using the Internet and other library resources. Learn about the education, licensing, credentialing, professional organization, working conditions, and other aspects of the profession.

Write a one to two page summary discussing different aspects of the profession. Cite your source using APA style guidelines.

With a better understanding of change management in healthcare, consider the impact of a new electronic health record (suppose a facility is moving from paper to an electronic health record) on the roles listed in the following table. The the tip outlined on the side will help you answer the questions the table below.

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With a better understanding of change management in healthcare, consider the impact of a new electronic health record (suppose a facility is moving from paper to an electronic health record) on the roles listed in the following table. The the tip outlined on the side will help you answer the questions the table below.