Discuss some of the reasons why a claim may be rejected.

There are several steps to take when submitting a claim form to the insurance company for reimbursement.

The result of a clean claim is proper reimbursement for the services the facility has provided.

In this assignment, you will be addressing the claims submission process and the follow-up.

Write a 2–3 page report; APA format.

Include the following in your submission:

· List all of the information that is important before the claim can be submitted.

· Discuss some of the reasons why a claim may be rejected.

· What steps should be taken to check the claim status?

Describe the impact of these issues on your department.

Choose two issues or challenges that the leaders of today’s health care organizations face. Select from among the following topics:

1.Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services)

2.Reorganization in Response to Merger or Consolidation of Services

3.Layoffs as a Result of Declining Revenues

4.Influx of Registry, Part-Time, and Temporary Contract Staff

5.Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars

6.Poor Job Satisfaction Rates Resulting in Turnover

You are the manager of an ancillary service department at a large, 500+ bed hospital. Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following:

1.Inform the staff of the two issues (from the topics provided) your organization is facing.

2.Describe the impact of these issues on your department.

3.Describe how improved communication, collaboration, and teamwork can improve conditions in your department.

4.Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration.

5.A minimum of three academic references from credible sources are required for this assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

, explain how the values of the organization are or are not reflected in these statements.

Find an organization related to your health care discipline and identify the mission and vision statement. Based on your experiences as a member of the health care team, explain how the values of the organization are or are not reflected in these statements.

1.Identify at least two technology innovations to connect patients, providers, and insurers across the care continuum.

Explore the technology systems offered by Nanthealth, a provider of “telehealth” and health management services via the following link:

http://nanthealth.com/

Prepare a brief (8-10 slides) PowerPoint presentation in which you do the following:

1.Identify at least two technology innovations to connect patients, providers, and insurers across the care continuum.
2.Describe how the technologies work to provide patients and providers with data necessary for health care decision making.
3.Discuss how the real-time data encourages outcome-focused planning.
4.Predict what impact the technology will have on future health care delivery. Provide rationale and examples.

Presentations must include speakers’ notes on each slide, as well as references for the presentation. A minimum of three academic references from credible sources are required for this assignment. The slide count (8-10 slides) does not include the introduction and References slide(s).

 

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Explain the importance of active listening in the workplace.

Assignment 1:  Write a 700- to 1,050 word essay in which you do the following:

  • Explain the importance of active listening in the workplace.
  • Explain how supportive and defensive climates can improve relations in the workplace.
  • Provide examples of the above.

Format your essay consistent with APA guidelines.

 

Assignment 2:  Imagine you are a supervisor in a health care office and you want to address this topic with your employees.

 

Write a 350- to 700-word memo to your employees in which you do the following:

  • Describe the principles of verbal and nonverbal communication.
  • Provide examples of how verbal and nonverbal communication can improve relationships in the workplace.

Describe the role the patient history and physical exam played in the diagnosis.

Case Study 4:

 

A middle-aged female presents to the office complaining of strep throat. She states she suddenly developed a sore throat yesterday afternoon, and it has gotten worse since then. During the night she felt like she was chilled and feverish. She denies known recent contact with anyone else who had strep throat, but states she has had strep before and it feels like she has strep now. She takes no medications, but is allergic to penicillin. The physical examination reveals a slender female lying on the examination table. She has a temperature of 101 degrees Fahrenheit, heart rate of 112, respiratory rate of 22, and blood pressure of 96/64. The head, eyes, ears, nose, and throat evaluation is positive for bilateral tonsillar swelling without exudates. Her neck is supple with bilateral, tender, enlarged anterior cervical nodes.

 

 

 

To prepare:

 

•Review this week’s media presentations and Parts 5–8 of the Buttaro et al. text.

 

•Reflect on the provided patient information including history and physical exams.

 

•Think about a differential diagnosis. Consider the role the patient history and physical exam played in your diagnosis.

 

•Reflect on potential treatment options based on your diagnosis.

 

 

 

POST 1 TO 2 PAGES ON  :

 

Explanation of the differential diagnosis for the patient in the case study that you selected. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis.

 

 

 

Describe what topic you selected, the search term(s) that you used, and the number of results found at each level of the hierarchy.

Literature Searches

An important step in the EBP process is reviewing the current body of literature to better understand the subject or topic in which you are interested. By conducting a review of the literature, you are building foundational knowledge about the topic; later, you can use this background to build new insights. Developing a strong grasp of a topic can only be garnered by taking the time to thoroughly search for relevant information and resources.

For this Discussion, you will practice searching the literature to find evidence on a specific topic.

To prepare:

  • Choose a simple search term(s) relating to a topic of your PICOT question.
  • Review the information on the evidence hierarchy discussed in Chapter 2 of the course text, in the article, “Facilitating Access to Pre-Processed Research Evidence in Public Health,” and in the multimedia presentation “Hierarchy of Evidence Pyramid,” found in this week’s Learning Resources.
  • Review the information on the Walden Library’s website, “Levels of evidence.” Take a few minutes to explore the different types of databases available for each level of evidence and focus on the meaning of filtered and non-filtered resources.
  • Conduct a literature search in the Walden Library on your selected topic using the databases that you reviewed. Use at least one database for each of the three levels of filtered information and at least one unfiltered database. Record the number of hits that you find at each level of the hierarchy of evidence.
  • Select one article from the results at each level of the hierarchy. Compare the articles based on the quality and depth of information. What would be the value of each resource if you were determining an evidence-based practice?

Post on or before Day 3: 

  • (1)a summary of your search.
  • (2) Describe what topic you selected, the search term(s) that you used, and the number of results found at each level of the hierarchy.
  • (3) Compare the types of information found in the articles from different levels and the value of the information from each level.
  • (4) Highlight a useful tip that you could share with your colleagues about conducting an effective literature search.

REQUIRED RESOURCES

How will you address each area and improve understanding, collaboration, motivation, and positive attitude?

Conflict may occur in any work environment, whether it is in the clinical setting, another department, or another organization. It is important to understand how conflict arises and how conflict is managed through effective communication.

The behavior of a leader has a direct impact on the motivation of his or her team. It is crucial for a leader to understand how his or her behavior and conflict-handling ability impact the care of patients.

Here is a scenario of a leader who is willing to handle conflicts in his or her workplace.

You are promoted to a management position in a small organization. There are four full-time members and three part-time members. You have a department manager currently overseeing the operations. You are excited to begin with your new assignment and have completed orientation. You heard some rumblings from the staff development team, “You have your work cut out for you in this department!” It does not sound promising, yet you are filled with energy, a positive attitude but a bit concerned as you do not want to appear bossy. You lack a bit of confidence since they are seasoned team members and you are new to the organization.

Once you begin your first day, you decide to meet with everyone as a group and individually over the next few days. What you are uncovering is disturbing and you quickly realize that the team members have lots of conflicts within the department. In a nutshell, this is what you have discovered:

  • The department manager thinks she is in charge since clients, customers, or patients have specialized needs. She is stern faced and does not seem to smile, yet she does not admit it is her or her department’s fault if there is an error. She seems to enjoy the increasing conflict among the unit as it takes any “pressure” off her and she can continue to “tell people what to do.”
  • Two full-time administrative staff members do not like each other and refuse to work together. One feels the other cooks “strange food” and cannot understand her when she speaks, and she is too quiet. The other staff member feels the first one is too outspoken and not gracious and hurries through her assignments. They share a small office and their work is critical to the success of the organization as they oversee all billing, accounts payable and receivable, and schedule the large projects and services to other organizations. The rest of the staff members avoid going to this office as the tension is clearly increased in this room.
  • The part-time staff feel they are not being offered any extra shifts and sometimes they are asked not to come to work if the day is slow. They feel they are not valued and are demotivated by less pay. This is a critical time for them due to the economy crisis. When they are at work, they often bring their home problems with them and seem stressed when they have to work with the other team members.

Answer the following questions:

  • How will you address each area and improve understanding, collaboration, motivation, and positive attitude?
  • How does emotional intelligence play a role in encouraging the staff to cooperate and to be willing to make behavior changes?
  • What behavior theory will you research to develop your thoughts when you speak to each staff member?
  • How important is decreasing overall conflict in the workplace?
  • How can you develop a win-win approach?

Why is it important for you to take this course in biostatistics?

Search for 2 or 3 SPSS tutorials to help you learn how to use SPSS.  Answer the following about the websites.  Provide the website for the 2 or 3 tutorials that you found on SPSS?  What specific things were you searching for in these tutorials?  What did you like or dislike about the tutorials?  What did you find the most useful in these tutorials?

 

 

200 words

This course is designed to provide you with the knowledge and skills in application, evaluation, analysis, and interpretation of biostatistical data used to inform public health programs, policy, and practice. View the online video, “Careers in Biostatistics.” The video describes the education that a professional biostatistician receives at the University of North Carolina. More than likely you will be working with professional biostatisticians. Why is it important for you to take this course in biostatistics?