Think about an experience, positive or negative, that has affected the course of your life.…
There are five steps in the claims adjudication process. Initial processing is the first step. Initial processing finds any problems such as; name, identification number, or the plan of service code is wrong. This has to be fixed before anything further can happen. Automated review is a system that checks for ten things that maybe reflected on their payment policy. The review checks for the following; patient’s time limits for filing claims, referral forms, preauthorization, and the patient’s eligibility benefits, bundled codes, non-covered services, medical review, concurrent care, utilization review, and duplicate dates of service. The third step is manual review. Manual review happens if problems occur from the previous review; the claim is suspended and set aside for development. This step is usually followed to review the medical necessity of an unlisted procedure. Determination is the fourth important step. This is where the decision is made to pay it, deny it, or to pay it at a reduced level. If the service falls within normal standings, it will be paid. If it is not reimbursable, the item on the claim is denied. If the examiner determines that the service was at too high a level for the diagnosis, a lower-level code is assigned. The last step is making a payment. If payment is due, the payer sends it to the provider along with a transaction that explains the payment decisions to the provider. Adjudication process is an important process because it checks for any errors that may have been missed on the claim, this will allow for a more accurate process and things will be done in a timely manner.…
Display "This program will break down the weight of an item from pounds to ounces, and will then give you the price per ounce for the product listed."…
The credit card data theft at TJX Companies is considered one of the worst ever. The case is significant because of a lack of appropriate security and control.…
Mark S Merkow, Jim Breithaupt. (2006). Information Security. Principles and Practices- Chapter 4. Retrieved from Mark S Merkow, Jim Briethaupt, IT244-Intro to IT Security.…
How does HIPAA serve to protect patient rights? What areas of the JSBMHA did HIPAA compliance impact? What actions should the JSBMHA director take about the HIPAA violation? Explain your answers in detail.…
1. Using the Consolidated Statements of Cash Flows, prepare a summary analysis for the years ended July 3, 2004, June 28, 2003, and June 29, 2002. Analyze the cash flows for Candela Corporation, Inc. for all three years.…
A census is the process of acquiring and recording information from the general public to determine population or housing numbers. For the 2010 census, the United States Census Bureau decided to implement a program called Field Data Collection Automation (FDCA). The program was intended to improve the data collection process by using handheld electronic devices. The mobile handhelds were to canvass addresses during the initial stage of the census.The FDCA program was important to the U.S. Census Bureau because it would replace the millions of paper forms and maps that were previously required to complete the census (Laudon&Laudon, 2011, p413). It was also important because it was meant to reduce costs, improve data quality, improve data collection efficiency, and encourage people to participate. Unfortunately, the FDCA program had problems.…
An example of this would be, if the speaker gives a long presentation, which includes key elements of the message. In this case key elements would be lost, so it is imperative to emphasize the points of the message with a method of repetitious messaging; another method that can be utilized for the purpose of communicating main…
The three dimensions to business problems are Organizational, Technological and People. With Organizational dimension comes outdated business processes, political conflict, complexity of task and inadequate resources to name a few. Technological dimension problem comes with outdated software, inadequate database capacity, rapid technological change and others. People dimension problems are lack of employee training, legal and regulatory compliance, indecisive management and lack of employee support and participation. Three dimensions in my current workplace are people; there is a lack of basic knowledge concerning applications such as Microsoft Office and in house database applications. Another example is Technology; there are workstations and servers that have been outdated for years, just as certain applications such as Adobe Acrobat and Microsoft Office are behind in versions. With the organization part, I have noticed there are many political issues between managers and employees there is a no respect for either party. To add, there is no a guideline or documentation on the procedures for tasks to be executed; this is when new employees arrive there is major chaos.…
The financial statement can show the records of the financial activities of a business. It was designed for common people to be able to read and understand this information. Three strengths of the financial statement is it that the owners and managers are able to understand the financial position of the company, this also allows individuals the ability to evaluate the historical and prospective financial performance, and this statement gives a vivid picture of the company’s financial health which will be the base of the owners and managers decision making. This type of foresight is important to the affects of a success in continuing of the company’s operation. Employees also can benefit from this information especially those in a labor union or in bargaining with upper management for a promotions based of the proven thriving performance. For the investors, the strengths of the financial statement give them a clear picture on whether or not to invest more or less in the future.…
When I started my first job in an eye clinic, I was hired to work the front desk of the main office along with three other ladies. I was the youngest at 22 , one gal was about 5 years older than myself, and the other two were in their early 60's. One of the older ladies had worked there a significant amount of time while the other two and myself were hired at the same time. There was an initial friction between one of the older ladies and my younger co-worker and myself. We thought she was bossy and tried to micro-manage us even though she was not in a supervisory position. She also would try and tell us how the older patients liked to be spoken to. After a while, management stepped in to try and mediate the conflict. As it turned out, my bossy co-worker was simply taught her work ethic and interpersonal skills in a different era. She felt more senior than my co-worker and I because she was older, with more life experience. She also thought that being from an older generation herself, that she knew how to communicate better with our patients. We were all trying to help our patients, do our jobs well, and effectively communicate, but our different backgrounds and significant difference in age, were creating an interpersonal conflict.…
Overall Theme We will explore fundamental assumptions of cost functions and discuss the relationships between cost behaviour, cost estimation and cost prediction. The concept of cost driver analysis and its application to cost estimation and cost management will also be discussed. We will also describe how to estimate cost behaviour using managerial judgment, engineering methods and other quantitative techniques.…
List the steps in preparing a work sheet in their proper order by writing numbers 1 – 5 in the blank spaces provided.…
There are three steps in the scientific process, unsystematic observation, building theories, and evaluating propositions. I have evaluated my personality many times in hopes to better myself. When I was younger I went through relationships like they were candy. I always blamed the other individual because of course I could do nothing wrong. A close friend of mine one day pointed out that I am not the same person I am with friends as I am with my boyfriends. At first I decided to not listen and thought she was being ridiculous, but as my relationships continued to fail, I thought maybe it was me, so I began to do an evaluation on myself with my boyfriend at the time. When I was with my friends I was extremely outgoing, fun, was always laughing, and making my friends laugh. I wanted to investigate if I was also this person when in a relationship or if my personality did transform. I started to observe myself by paying attention more to our conversations and what we would do when together. I soon was seeing I would start up arguments quite frequently and was very opinionated, stubborn, and it was my way or the highway type of attitude. Upon realizing this I turned to my boyfriend at the time and asked if he had noticed a difference from when we were friends to being a couple. He did not mention my personality but he did mention that things were more stressful and that we argued a lot more. The relationship after time became extremely rocky and we were on and off, I knew I loved him, but for some reason I could not change and could not figure out why I was acting this way. I then started to see a councilor so I could better figure out what was going on inside of me. When with the councilor we were able to build theories one of the theories was the fact that I feel that I need to be dominant when it comes to males and she suggested that it could be from a time when I was badly mistreated by an ex. To evaluate this proposition I wrote a letter to my ex…