In this module, you learned about the significance of staffing in healthcare strategic planning initiatives and the revenue cycle. You also looked at the role of leadership to i

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IHP 630 Module Five Project Preparation Guidelines and Rubric

Overview

In this module, you learned about the signi�cance of staf�ng in healthcare strategic planning initiatives and the revenue cycle. You also looked at the role of leadership to improve team

performance and the areas in the back-end revenue cycle.

To recap, the components in the back-end revenue cycle include (but are not limited to) the following areas:

Claims Production

Claims Submission

Determining Expected Reimbursement

Adjudication

Bene�ts Statements

Claims Reconciliation

Denial Management

In this assignment, you will create an analysis report on the staf�ng system of a healthcare organization based on the identi�ed areas of the back-end process of the revenue cycle.

This assignment will help you describe best practices for revenue-cycle staf�ng models and align staf�ng models with strategic planning initiatives. It will also enable you to demonstrate how

key leadership competencies improve revenue-cycle team performance. From a healthcare management perspective, this activity will help you understand how to set up and manage a robust

staf�ng process. This activity will help you prepare for sections 3 (Staf�ng Impact) and 5B (Work�ow Assessment Findings) in the course project.

Directions

Create an analysis report on the staf�ng requirements in the backend process of a healthcare organization.

If you need writing support, access the Online Writing Center through the Academic Support module of your course.

Speci�cally, you must address the following rubric criteria:

1. Staf�ng Competencies: Describe the staf�ng competencies needed for hiring team members in the back-end revenue cycle. Consider the following questions to guide your response:

What competencies are needed for the back-end processes of the revenue cycle?

What makes this competency speci�c to the healthcare domain?

2. Revenue Integrity: Explain the importance of the back-end processes of the revenue cycle for preserving revenue integrity. Consider the following questions to guide your response:

How do organizations incorporate operational ef�ciency in the back-end processes?

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How is compliance to regulatory requirements built into the back-end processes?

3. Role of Leadership: Explain the role of leadership in ensuring staf�ng competencies. Consider the following questions to guide your response:

What skillsets or knowledge should a leader look for when recruiting somebody for the back-end process?

How would the leader keep the team updated in skillsets and knowledge?

4. Lapses and Prevention: Identify processes to prevent lapses and/or gaps in the staf�ng model. Consider the following questions to guide your response:

What kind of lapses and/or gaps are possible across the entire process?

What are the possible reasons behind these lapses and/or gaps?

5. Impact of Failure: Discuss the impact of any failure in the claims production and claims submission areas of the revenue cycle. Consider the following questions to guide your response:

What are some of the possible events of failure that could happen in the �rst two areas?

Who would be impacted by such events?

6. Financial Impact of Declined Claims: Discuss the �nancial impact of initially declined claims and delayed payments to healthcare organizations. Consider the following questions to guide

your response:

Do healthcare organizations face the same �nancial impact for governmental and private insurance claims?

What steps can be taken by the back-end processes staff and by leadership to ensure these delays do not happen?

All the claims in your deliverable should be evidence based. Your citations should be from your independent search for evidence (not from the textbook, or module resources) of credible

sources and be current within the last �ve years. You are required to cite between 3-5 resources, with a minimum of three sources, at least one which is not also one of your Project One

resources. Refer to the IHP 630 Library Guide located in the Start Here section of the course for additional support.

What to Submit

Submit your analysis report as a 5- to 6-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Sources should be cited according to APA

style.

Module Five Project Preparation Rubric

Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value

Staf�ng Competencies Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Describes the staf�ng

competencies needed for hiring

team members in the back-end

revenue cycle

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 10

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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value

Revenue Integrity Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Explains the importance of the

back-end processes of the

revenue cycle for preserving

revenue integrity

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 10

Role of Leadership Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Explains the role of leadership

in ensuring staf�ng

competencies

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 10

Lapses and Prevention Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Identi�es processes to prevent

lapses and/or gaps in the

staf�ng model

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 15

Impact of Failure Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Discusses the impact of any

failure in the claims production

and claims submission areas of

the revenue cycle

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 15

Financial Impact of Declined

Claims

Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Discusses the �nancial impact

of initially declined claims and

delayed payments to

healthcare organizations

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 15

Articulation of Response Exceeds pro�ciency in an

exceptionally clear and

insightful manner

Clearly conveys meaning with

correct grammar, sentence

structure, and spelling,

demonstrating an

understanding of audience and

purpose

Shows progress toward

pro�ciency, but with errors in

grammar, sentence structure,

and spelling, negatively

impacting readability

Submission has critical errors in

grammar, sentence structure,

and spelling, preventing

understanding of ideas

10

Scholarly and Professional

Sources

Incorporates more than two

scholarly, current (within the

last �ve years) sources, or use

of sources is exceptionally

insightful

Incorporates two scholarly,

current (within the last �ve

years) sources that support

claims

Incorporates fewer than two

scholarly, current (within the

last �ve years) sources, or not

all sources support claims

Does not incorporate sources 10

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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value

APA Style Formats in-text citations and

reference list according to APA

style with no errors

Formats in-text citations and

reference list according to APA

style with fewer than �ve

errors

Formats in-text citations and

reference list according to APA

style with �ve or more errors

Does not format in-text

citations and reference list

according to APA style

5

Total: 100%