Financial Procedures in a Healthcare Organization 3-4 Pages APA Format

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Health insurance companies provide the majority of the payment for medical services that clinics and physicians deliver. After the care has been delivered, the medical record is reviewed for completeness, codes are applied, and the billing office submits the claim to the insurance company or other third party payer for payment. 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.

Discuss the following:

  • What does it mean to submit a clean claim?
  • 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.
  • State various reasons for the importance of a clean claim submission.
  • Address the consequences of not submitting a clean claim.
  • What steps should be taken to check the claim status?
  • As the practice manager, how would you ensure that the claims process results in clean claim submission and very few claim rejections.

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Nursing homework help

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Good response to the question Leanet. Many researchers believe that lack of knowledge about research and EBP is present in many nurses today. Even though it is being presented to students in nursing programs now, the connection between research, and its’ effects on daily practice is not made. Many nursing colleagues would rather ask each other for information than searching a database. Since nursing is such a high demand position and many facilities are understaffed many times, I believe this plays an important role in the disconnect. With the changing environment in regards to technology, and the availability at many facilities of internet access and medical librarians, one would think that conducting research would be more efficient and quick allowing evidence-based practice to be more accessible to the clinical nurse. Comments?

 

 

I NEED YOU TO COMMENT FROM THIS POST, IT IS A COMMENT FROM SOMETHING THAT I WROTE, SO PLEASE COMMENT BACK TO ONE OF THE PROFESSORS OF THE CLASS, DO NOT FORGET THE REFERENCE. NO MORE THAN 150 WORDS NEEDED.

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Discussion Questions needed (asap)

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(1)   Describe how the Iron Triangle can be used to assess health care. Give specific examples.

 

 

(2)   What do you think of the Nursing Home Compare and Physician Compare websites? Do you think they provide valuable information for consumers to support these important health care decisions?

 

 

(3) Open your web browser and search for the following video: “What Healthcare Will Look Like in 2020” by Stephen Klasko.

Discuss your thoughts with the class.

 

 

(4) Open your web browser and search for the following video: “Transparency: The Future of Health Care” by Press Ganey.

 

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Research Proposal Draft

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write a 1-page paper addressing the sections below of the research proposal.

Theoretical Framework

  • Overview and Guiding Propositions(s) Described in Theory
  • Application of Theory to Your Study’s/Project’s Focus

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TOWS Matrix

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For this assignment, you will complete a TOWS matrix and portfolio analysis, and use any other appropriate analysis tools, to determine alternative strategies for your health care organization’s future success. Include the following elements:

  1. Incorporate the use of new methodologies from the knowledge-economy management approach that might be appropriate for this organization.
  2. Correlate recent research findings regarding strategy management into your approach.
  3. Synthesize operational and financial components in your strategic planning process.
  4. Incorporate your findings from your current environment analysis.
  5. Preface your newly revised strategic plan with the core assumptions regarding environmental opportunities and threats, organizational strengths and weaknesses, and organizational behavior dynamics that are foundational to the strategy.
  6. Determine the organizational structure that best facilitates the strategy—functional, divisional, or matrix.
  7. Include a brief description of the proposed strategy that reflects the choices made regarding:
    • Product domain.
    • Market domain.
    • Level of investment in the respective product and market domains.
    • Positioning approach for achieving competitive advantage.
    • Maneuvers that will be used to implement the positioning approach.
    • Distinctive competencies or assets that will be relied on to gain and sustain competitive advantage.

Length of paper: 3–5 double-spaced, typed pages.

  • APA formatting: Resources and citations are formatted according to current APA style and formatting.
  • Resources: Use evidence from the literature to support your recommendations.

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Credit Risk Management Module 6

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Risk management practices within the financial sector are of particular interest to regulators. This is because failures within this sector disrupt the functionality of the financial system that derails economic growth and efficiency. We have referenced the subprime meltdown of 2007 several times within this course because it is the most prominent example of a massive risk management failure. In this assignment, you will evaluate the consequences of this failure.

For this assignment, you will write a minimum three-page paper (not including APA title or references pages). In this paper, please address the following:

 

  • Discuss why credit risk management within the financial sector is so significant.
  • Why do you think so many banks failed to properly manage risk prior to the financial collapse?
  • What are the consequences of failures of credit risk management and who do they affect?
  • What measures can banks employ to mitigate credit risks?
  • Be sure to include an introductory paragraph at the beginning and a concluding paragraph at the end of your paper.
  • Because your paper is required to be at least three pages in length, you should use subject headings to label your paper as appropriate.
  • Be sure to include APA citations to support your assertions and to inform your paper.
  • You will need to include an APA formatted reference page with this paper (separate from the body of your paper).
  • Be sure to proofread your paper to ensure that is free from all grammar and spelling errors.

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Class 1 Unit 5 DISCUSSION (DQ)

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Discussion

Team Dynamics

Reflect on your experiences as a member of a clinical team. What makes a team effective in terms of achieving expected outcomes for patients and agencies? What situations or conditions make it difficult for teams to work together?

 

  1. Textbook Readings

Advanced Practice Nursing: An Integrative Approach

  • Chapter 12: “Collaboration”
  • Chapter 13: “Ethical Decision Making”
  1. THINGS TO REMEMBER: 

 

  • Discussion post is at least 200 words.
  • Answers all questions with opinions/ideas creatively and clearly. Supports post using several   outside, peer-reviewed sources.
  • 3 References, try to find resources that are 5 years or less
  • No errors with APA format 6th Edition

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assignment

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The Assignment

 

Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

 

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nursing research

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Chapter 14

Data Collection: Testing and Observation

Initial Preparation for Data Collection

IRB approval

Selection of measures

Rater training

Creating and assembling forms and test packets

Test administration

 

2

Selection of Measures

Reliability

Has reliability been reported?

Has it been at acceptable levels?

Was it tested with similar populations under similar circumstances?

 

3

Selection of Measures

Validity

Same questions apply as reliability

Trustworthiness of qualitative procedures planned

Difficulty level

Time and energy requirements

 

 

4

Rater Training

If you are not collecting your own data training of raters should include:

Background information on the measures used

Confirming consent

Confidentiality

Safety precautions

 

5

Rater Training

If you are not collecting your own data training of raters should include:

Approach to participants

Handling emergencies and adverse effects

Administration of tests

Accurate recording

“Housekeeping” matters

 

 

6

Creating and Assembling Test Packets

Codebook

Order of questions and tests

Obtain permissions where necessary

Consider order effect

Consider practice effect

 

7

Test Administration

General considerations in testing situations:

Motivating participant

Providing privacy

Comfort of participant

Physical limitations of participant

Order of tests

 

8

Test Administration

General considerations in testing situations:

Accurate timing

Participant fatigue

Participant frustration

Effect of depression or anxiety

 

9

Tests of Function

There are four perspectives from which to approach measurement of function:

Actual performance versus report of performance

Capability versus usual performance

Self-report versus informant report

Appropriate to the group being evaluated

 

10

Physical Assessment Measures

Often used along with other measures

Require clinical expertise in administration

Training for specific test may be needed

 

11

Biological Tests

When collecting specimens for laboratory analysis:

Follow directions carefully

Avoid contamination

Maintain correct temperature

Use correct collection container

 

 

12

Biological Tests

When collecting specimens for laboratory analysis:

Process according to directions

Collect the correct amount

Adhere to the appropriate timing of the collection of specimens

Store and transport properly

 

 

 

13

Observation

Observation is often the first data collection method used when exploring a new research topic

Observation may be highly structured or unstructured, but it should always be systematic and purposeful

 

 

 

14

Structured Observation

Observation uses a set of codes, checklists or guides that specify what is to be observed and recorded

Recording may be done by hand or electronically

Observations are often done at regular time intervals

 

 

 

15

Naturalistic Observation

Naturalistic observation generally involves a smaller sample size and is more informal

It usually covers a longer observation time

 

 

 

16

Degree of Participation

There is a continuum in the degree to which the data collector participates in the activities under observation

Active: high level of comfort but may interfere with the ability to step back and observe

Moderate: strikes a balance between insider and outsider perspective

 

17

Degree of Participation

There is a continuum in the degree to which the data collector participates in the activities under observation

Nonparticipation: data collector can focus attention on the observations being made but it may take some time for participants to become comfortable with being observed

 

 

 

18

Entering the Field

When observing people, you need to gain their trust

It may require considerable negotiating skills

It is important to document efforts/activities to gain entry

 

 

 

19

What to Observe?

Time and data

Physical space description

People present

Actions and interactions

 

 

20

What to Observe?

Emotional climate

Implicit understandings, norms, and expectations

Timing and sequencing

Events

 

 

21

Recording Observations

Keep in mind the purpose of your study in mind as you record what you see

Notes taken on site should be brief but add detail as soon as possible after observation

Be sure to distinguish observation from opinion

 

 

22

Video Recording

Video recording provides a permanent record of your observations

It allows rich detail of an event to be captured but it does not always pick up subtle changes

It may affect the recorder and people being recorded

 

 

23

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Excel Assignment

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Assignment: Application: Basic Financial Calculations

Before you learned algebra, you first had to learn basic addition, subtraction, multiplication, and division. Similarly, before you can fully understand the finances of a health care organization, you first need to be able to apply basic financial calculations used in almost all domains of accounting. A firm grasp of these accounting concepts will better enable you to confidently make budgetary and resource decisions. In this Assignment, you complete calculations that will familiarize you with some of the necessary basic accounting concepts.

Based on the information and financial statements below, calculate the following financial ratios in an Excel Spreadsheet:

    • Current Ratio

= Total Current Assets / Total Current Liabilities

    • Days of Cash on Hand

= Cash / (Total Operating Expense / 365 days)

    • Age of Accounts Receivable

= Accounts Receivable / (Net Patient Service Revenue / 365)

    • Age of Physical Plant

= Accumulated Depreciation / Depreciation Expense

    • Debt to Equity Ratio

= [Long Term] Debt / Net Assets

    • Debt to Assets Ratio

= [Long Term] Debt / Total Assets

    • Collection Rate

= Net Patient Service Revenue / Gross Patient Service Revenue

    • Operating Margin Ratio

= Gain or (Loss) from Operations / Net Patient Service Revenue

Note: For those Assignments in this course that require you to perform calculations you must:

  • Use the ‘Week 3 Application Assignment Template’ from your Learning Resources
  • Show all your calculations and formulas in the spreadsheet

 

A title and reference page are NOT needed in this assignment. Put your name and assignment at the top of the Excel spreadsheet.

For those not comfortable with the use of Microsoft Excel, this week’s Optional Resources suggest several tutorials.

To prepare:

  • Review the information in this week’s Learning Resource

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