Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
In this assignment, you will demonstrate your mastery of the following course outcomes:
? Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
? Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
? Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
? Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
? Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to
educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn
impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has
asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals
vary in size, location, and focus. Becker?s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the
hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There
are several ways to accomplish this. Choose one of the following:
? If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses.
? Conduct research through articles or get information from professional organizations.
Below is an example of how to begin framing your analysis.
A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what
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