Assignment: Billing and Reimbursement
Assignment: 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.
Plagiarism is the use of someone else’s ideas without giving proper acknowledgment. The term “plagiarism” includes, but is not limited to, the use, by paraphrase or direct quotation, of the published or unpublished work of another person without full and clear acknowledgment. It also includes the unacknowledged use of materials prepared by another person or agency engaged in the furnishing or selling of term papers or other academic materials.
The Modern Language Association’s MLA Handbook for Writers of Research Papers defines plagiarism as follows:
- repeating another’s sentences as your own,
- adopting a particularly apt phrase as your own,
- paraphrasing someone else’s argument as your own,
- presenting someone else’s line of thinking in the development of a thesis as though it were your own.
In short, to plagiarize is to give the impression that you have written or thought something that you have in fact borrowed from another.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Please number the pages of your essay (except for the title page).
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
Final check list
Before handing in your paper, please check the following items:
The pages are numbered.
The paper includes citations and a bibliography.
You have spell-checked, grammar-checked, and proofread the paper.