In my own words how, HIPPA, ICD, CPT, and HCPCS influence each of the ten steps of the medical billing process is that when it comes to medical billing and the coding process, there is a special task that must be completed by the billing staff members of any medical facility, whether it is a small doctor’s office or a large hospital. They must provide quality care in the mean while protecting the patients’ privacy and expediting the payment of services rendered. There are ten steps to this process: pre-registration, establish the financial responsibility, the checking in and checking out of patients’, reviewing the coding compliance, checking the billing compliance, preparing and transmitting the claims, monitor payer adjudication, creating patient statements and the handling of collections. HIPPA policies are carefully reviewed by the patient’s informing them of the process necessary in transmitting their claims and the facilities devotion to their confidentiality.…
References: Lombardi, D. J., Schermerhorn, J. R., & Kramer, B. (2007). 4. In Health care management. [Adobe Digital Editions].…
7. Type the email address of the person to whom it’s to in the “To” box…
1.) What everyday changes (if any) can you make to increase the amount of energy expended in your day-to-day activities?…
Registered health information technicians (RHITs) are custodians of one of the most important tools in modern health care—the medical record. These professionals ensure that patients’ histories are accurate, complete, up to date and properly entered into the clinical database. Thanks to the work of RHITs, doctors and other providers have a full range of information at their fingertips which can be used to plan and deliver high quality care.…
Currently, the Joint Commission on Accreditation of Healthcare Organizations visits the healthcare providers in the United States in approximately three years. After visiting the healthcare facilities, they then grade the entire environment of care. It is not a must for a healthcare organization to submit to the inspection .moreover, the Joint Commission on Accreditation of Healthcare Organizations does not have enforcement power and also does not consider business recovery during the inspection (Burtles, 2007).…
For an organization, understanding the issues around regulatory compliance can be a difficult and frustrating attempt. A short-term action an organization has to use to come into regulatory compliance is identifying standards of care. An understanding of professional practices is a key element of the review of professional liability exposures. Knowledge of such standards is crucial in controlling risk during the development and implementation of new and alternative treatment regimens. A long-term action is ensuring that the regulatory approval process is conducted in a timely and cost-effective manner. The primary purpose of measuring consumer satisfaction is to improve the quality of care provided should always be kept in mind. This principle should guide in what data are collected, how they are collected and most importantly, how they are analyzed and reported.…
A root cause analysis (RCA) is a method by which we can examine a serious adverse event and identify the cause, or causes, that led up to the event. Although personnel are involved in these events, the primary purpose of the RCA is to identify the cause, not to assign blame (Agency for Healthcare Research and Quality, 2014). It is through identifying a cause, or causes, of an adverse event that we can improve on patient care processes and thereby patient safety. The RCA is designed as a specific protocol that starts with data collection looking at the sequence of events that led to the adverse event (Connelly, 2012). Additionally a review of the patient record along with interviews of the personnel involved provides valuable insight into how the patient care processes broke down. Hospitals are complex organizations that have many layers of safety erected to protect the patient from action taken by healthcare providers. These safety measures include policies, protocols, and guidelines. The reason for multiple layers, or measures, is that there can be weaknesses in the process that forms an opening for an error to occur (Elliott, Page, and Worrall-Carter, 2012). The fundamental goal of the RCA is to prevent future patients from being harmed through understanding how an adverse event could occur.…
The compliance process is critical when it pertains to the billing and coding process. It is imperative for Medical Insurance Specialist to remain current on the patient’s participation in contract as well as the medical insurance policies, so there will not be any billing errors. Maintaining a communication with the payer will also prevent billing errors. Such regulations and laws are in place for to protect the patient’s financial state, prevent errors of billing and coding, and to link procedures and diagnoses correctly. Becoming knowledgeable of the billing rules should also help prevent billing errors as well. In this assignment, I will discuss how important it is for medical staff to be knowledgeable of the billing and coding compliance strategies.…
Hospitals are one of the many organizations that must comply with regulations to keep patients and staff safe and as well as maintain the quality of care. Ideally, a good care system for patients includes medical professionals as well as friends and family to compliment each other in providing for patient needs. Because patients require care from medical professions in hospitals, there are provisions that the hospital must follow. “Compliance means conforming to a rule, such as a specification, policy, standard or law. Regulatory compliance describes the goal that corporations or public agencies aspire to in their efforts to ensure that personnel are aware of and take steps to comply with relevant laws and regulations (Compliance and Regulatory Compliance, 2013)”. For this reason there are terms of compliance that hospitals must adhere to. The Joint Commission Handbook serves as a means of regulation and compliance for hospitals and other such facilities. There are four categories that the Joint Commission focuses on during the accreditation audits for a hospital: Information Management which involves the efficient management of health information and accuracy, Medication Management involving labeling and sterility, Communication involving verification, and Infection Control to minimize spread and infection.…
How do the philosophy and culture of the risk-management and quality-management policies influences organizational performance?…
JCAHO was established in 1952 as a confidential not for profit organization. JCAHO performs periodic on site surveys to confirm that the healthcare organizations act in accordance with the standards, and also make efforts to advance the care, and services provided. JCAHO duty is to improve patient care. The key source of JACHO is to help hospitals in ensuring that employees meet the capability requirements. The structure of JCAHO works by responding to a voluntary call by the health care provider. Measures and indicators are used to evaluate the quality of care, afterwards the result of this evaluation is processed and the information is used to deny or approve the accreditation of the organization (Joint Commission Competency Program, 2011).…
The Joint Commission has a list of national patient safety goals were set in place to guide improvements in safety of patients and to help highlight any problem areas within the healthcare systems regarding patient’s safety (The Joint Commission, 2013). The goals created for patient’s safety are listed and described through evidence based solutions in order to assess each goal. The Joint Commission focuses on several topics, all of include an importance in patient safety and their quality of care (The Joint Commission, 2013).…
Healthcare consist of a variety of specialized services to meet each patient’s needs. In order to provide the best patient care, it is important for each provider to have the tools and resources that is needed to improve the patient’s health. The industry is broken down into different organizations as it is difficult for one provider to render all aspects of services. Providers have to be credentialed and licensed to treat different type of illnesses and diseases. If one goes to their primary care physician due to a broken foot, he typically would refer the patient to see an Orthopedist, who specializes in broken bones. Healthcare organizations are the same way, not one facility cannot treat all diagnosis.…
A second positive impact is that due to the SOLER guidelines being followed by the practitioner the service user may develop a closer relationship with the carer. This may influence a speedier recovery as the carer will be able to identify any issues with the patient more easily and quickly due to the close relationship. The patient will feel more positive about asking for help if the delivery form the carer is positive. The carer will also benefit as if the carer gains a more relationship with the patient then they will be able to go into more depth about the patient’s worries this will make them feel more…