o healthcare organizations face the same financial impact for governmental and private insurance claims?
Overview
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 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
Benefits Statements
Claims Reconciliation
Denial Management
In this assignment, you will create an analysis report on the staffing system of a healthcare organization based on the identified areas of the back-end process of the revenue cycle.
This assignment will help you describe best practices for revenue-cycle staffing models and align staffing 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 staffing process. This activity will help you prepare for sections 3 (Staffing Impact) and 5B (Workflow Assessment Findings) in the course project.
Directions
Create an analysis report on the staffing 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.
Specifically, you must address the following rubric criteria:
Staffing Competencies: Describe the staffing 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 specific to the healthcare domain?
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 efficiency in the back-end processes?
How is compliance to regulatory requirements built into the back-end processes?
Role of Leadership: Explain the role of leadership in ensuring staffing 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?
Lapses and Prevention: Identify processes to prevent lapses and/or gaps in the staffing 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?
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 first two areas?
Who would be impacted by such events?
Financial Impact of Declined Claims: Discuss the financial 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 financial 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 five 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.
5 pages
Describe five potential issues and/or roadblocks that might happen while delivering the lesson, based on the needs of the selected group of students.
Select a 3-5 grade level and a corresponding Arizona or other state standard based on the Number and Operations-Fractions domain.
Compose an aligning learning objective and design appropriate activities for a selected group of 3-4 students, of varying academic levels, from the Class Profile.
Using the COE Lesson Plan Template, complete the lesson plan through the Multiple Means of Engagement section, making sure the activities are supported by the recommendations found in the topic Resources.
For your differentiated activities, specifically address:
Fraction tasks, including area, length, and set/quantity models; or
Equivalent fractions. In the Multiple Means of Engagement section, draft five questions you could ask students during the lesson that promote conceptual understanding related to fractions.
In the Multiple Means of Representation section, rovide possible solutions to each potential issue.
Ms. Edelson is an 84 year?old African?American widow living alone in her own home. She has lived in the same neighborhood for over 45 years. Her husband died two years ago and since then her health has deteriorated. She and her husband had no children and her closest relatives are nieces and nephews who live nearby, but who visit infrequently.Over the past year, Ms. Edelson has become increasingly hostile and suspicious. She has accused her nieces and nephews of trying to take advantage of her when they offer to help her with shopping and transportation. Ms. Edelson owns her home and thanks to a life?long pattern of frugality, she has a comfortable savings account. She suspects that her relatives just want her money and she has essentially shut them out of her life. Other than a few neighbors who visit her once in awhile, Ms. Edelson has few social contacts.Questions:What are some of the assumptions you might make about the client and/or situation?What are some possible assumptions the client might make about you?What preparation for the first session would you want to do?
Read the following Case Study and then answer the questions below. Ms. Edelson is an 84 year?old African?American widow living alone in her own home. She has lived in the same neighborhood for over 45 years. Her husband died two years ago and since then her health has deteriorated. She and her husband had no children and her closest relatives are nieces and nephews who live nearby, but who visit infrequently.Over the past year, Ms. Edelson has become increasingly hostile and suspicious. She has accused her nieces and nephews of trying to take advantage of her when they offer to help her with shopping and transportation. Ms. Edelson owns her home and thanks to a life?long pattern of frugality, she has a comfortable savings account. She suspects that her relatives just want her money and she has essentially shut them out of her life. Other than a few neighbors who visit her once in awhile, Ms. Edelson has few social contacts.Questions:What are some of the assumptions you might make about the client and/or situation?What are some possible assumptions the client might make about you?What preparation for the first session would you want to do?
What does the Institute for International Economics suggest about the benefits of free trade? According to the Institute for International Economics study, a move toward free trade would cause disruption in employment. Is it still worth pursuing free trade if it means that some people lose their jobs?
Case Analysis #2
Due Sunday by 11:59pm
Points 75
Submitting a file upload
Reread the Country Focus Turkey, Its Religion, and Politics in chapter 4 and address this question:
Are the concerns of those opposing Turkeys admittance to the European Union well-founded? Can Islam, capitalism, and globalization co-exist?
Reread the Country Focus Estimating the Gains from Trade for America in Chapter 7 and address these two questions:
What does the Institute for International Economics suggest about the benefits of free trade?
According to the Institute for International Economics study, a move toward free trade would cause disruption in employment. Is it still worth pursuing free trade if it means that some people lose their jobs?
Reread the opening case NAFTA 2.0: The USMCA in Chapter 9 and address these three questions:
Discuss NAFTA in the Trump era. What changes to trade based on the new USMCA agreement would he like to see?
As an American consumer looking for a new car, what does NAFTA mean to you? Does your response change if you are a consumer from Mexico or Canada? What about under the new USMCA?
As CEO of an auto company with manufacturing facilities in Mexico, what does the new USMCA deal mean to you?
Case Analyses must follow the following guidelines:
You must give a quality analysis of the cases based on the key terms showing mastery, using clear logic, and supporting facts. Also, the analysis must directly address the case using chapter readings and research.
Case Analyses test the understanding of key elements of International Business, therefore, they must be thoroughly addressed.
You must use citations with references to document information obtained from sources. The key elements and concepts of International Business are found in the sources listed in the syllabus (it is your duty to search for them, read, analyze, evaluate, summarize, paraphrase in your answers, and cite the authors who wrote the articles, books, term papers, memoirs, studies, etc. What it means is that you will have not less than 5 references from the listed sources.
Grammatically correct paper, no typos, and must have obviously been proofread for logic.
Avoid direct quotes, you must paraphrase and cite. If you direct quote (two words or three words, mission statements, phrases, etc.) you must include in your citation parenthesis page number or paragraph number. When you direct quote Brand taglines or Mission Statements, you must include the Brand name or Company name in the citation parenthesis.
Key terms or Questions must be typed out as headings, with follow up analysis or answers in paragraph format, and a summary or conclusion to contextualize your analyses at the end of the paper.
The Cases Analyses must be in APA format
Making money from apps is possible but difficult. There are hundreds of thousands of apps available. The revenue generated from an individual app is typically very small, and the app stores take a 30% cut of all the revenue that your app generates. How do you get people to pay you to use yours? What are the different ways you can collect money for the use of your apps? More importantly, how can you get a lot of people to pay you to use the app so that the revenue generates enough to fund further development or expansion?
Making money from apps is possible but difficult. There are hundreds of thousands of apps available. The revenue generated from an individual app is typically very small, and the app stores take a 30% cut of all the revenue that your app generates. How do you get people to pay you to use yours? What are the different ways you can collect money for the use of your apps? More importantly, how can you get a lot of people to pay you to use the app so that the revenue generates enough to fund further development or expansion? These are some of the questions that many developers ask. The two primary audiences are typically the employees of an organization for which the app was developed or the public. Many aspects of publishing are the same for both audiences. However, some important differences exist that the developer needs to be aware of. Likewise, publishing Android versus iOS apps can be very similar, but with some significant differences. Some questions have concrete answers; others are still very much open for debate.
an office manager, you are continuously exploring future opportunities or risks that could have an impact on your organization or the health care industry. Discuss the following with the class: What are some current trends in health care that have an impact on organizational change? Provide specific examples. What do you predict will happen with these trends in the future?
As an office manager, you are continuously exploring future opportunities or risks that could have an impact on your organization or the health care industry.
Discuss the following with the class:
What are some current trends in health care that have an impact on organizational change? Provide specific examples.
What do you predict will happen with these trends in the future?
Response of 175 words
pretend you’re founding a new international NGO. What kind of NGO would you start?My electricity bill last month was as high as $349.11, which gave me a sudden inspiration. I plan to create an NGO called Global Energy Equity Foundation (GEEF).1. What kinds of international human rights issues would your NGO address?
Respond to the following Discussion:For the discussion, pretend you’re founding a new international NGO. What kind of NGO would you start?My electricity bill last month was as high as $349.11, which gave me a sudden inspiration. I plan to create an NGO called Global Energy Equity Foundation (GEEF).1. What kinds of international human rights issues would your NGO address? (Think beyond US domestic politics; try to pick something that could have international resonance and importance). You can give the NGO a name if you like, or you can keep the idea general. Think about what type of population your NGO will serve. Addressing the human rights implications of energy poverty. Millions worldwide lack access to reliable and affordable energy, which has ripple effects on their health, education, and economic opportunities. Energy poverty can disproportionately impact marginalized groups, such as indigenous peoples, rural communities, and women. GEEF would champion the right to sustainable and equitable energy for all, promoting renewable energy solutions that are accessible and beneficial to these populations.2. Would your NGO have a friendly relationship with states, or it be more like a foe or foil to states? What kind of states would it get along best with?GEEF would maintain a cooperative yet critical relationship with states. Its primary objective is to collaborate and provide solutions; however, GEEF would not shy away from holding states accountable.GEEF would align best with states that prioritize sustainable development, have active renewable energy policies, and are signatories to international agreements such as the Paris Agreement. These states recognize the importance of addressing climate change and ensuring energy access for their citizens.3. To get your NGO going, you need resources and mentorship from an established NGO. What is one existing NGO that your new, hypothetical NGO could reach out to for a partnership? Tell us about this existing NGO and how it could help. I would like to partnering with an Established NGO which called Practical Action.Practical Action is a UK-based organization works with communities worldwide to provide sustainable solutions to challenges in energy, water, and other sectors. They focus on using technology to address poverty and have considerable experience in promoting small-scale renewable energy solutions in remote and underserved regions.Practical Action has built a broad network of donors, partners, and communities that could be leveraged for GEEF’s initiatives. Also,As a new NGO, GEEF would benefit immensely from the insights and training provided by Practical Action’s seasoned professionals.Reference?Practical Action
Respond to a colleagues post who has selected a different value. Describe whether or not your colleagues post swayed your point of view. Does your opinion change when on reporting in different contexts? Why or why not?
Respond to a colleagues post who has selected a different value. Describe whether or not your colleagues post swayed your point of view. Does your opinion change when on reporting in different contexts? Why or why not?
_______________________
Colleagues response
Based on previous outcomes of something that has occurred (odds ratio), logically, it gives you the conditional probability that it will continue to occur (Warner, 2013). This is based on a logistic regression. In other words, the regression tests you run to analyze data will yield results proving or disproving a hypothesis.
Whereas a binary logistic regression occurs when the Y variables are predicted from the X variables and do not need the assumptions (Warner, 2013). The goal is to analyze what the odds are of a given outcome. There are linear relationships between both variables as well. The variables have to be independent of each other. If you add to that assumption, the odds will either reinforce the probability or go against it.
Using a binary logistic regression means taking additional steps would be the best way to analyze the data collected. Because you want to show that everything is linked to each other in your study, it would mean taking the extra steps to prove that the hypothesis is valid and that the original idea is what it says it is, especially when a simple regression test would not work with multiple variables.
Reference
Warner, R. M. (2013). Applied statistics: From bivariate through multivariate techniques (2nd ed.). Thousand Oaks, CA: SAGE Publications
The lead-out is where you conclude the paragraph and its corresponding argument. It also provides an opportunity to emphasize your unique voice as a scholar. To generate the lead-out, writers ask themselves questions such as What is the lasting impression I want this paragraph to have? Ultimately, what is this paragraphs argument about? What is the overall significance of the idea presented?
APA format, in-text citation, references include
Part 1: ( Use for part 1 attachment to do)
The lead-out is where you conclude the paragraph and its corresponding argument. It also provides an opportunity to emphasize your unique voice as a scholar. To generate the lead-out, writers ask themselves questions such as What is the lasting impression I want this paragraph to have? Ultimately, what is this paragraphs argument about? What is the overall significance of the idea presented?
A strong lead-out sentence wraps up your paragraph neatly for the reader. Often, though, your writing wont end with just one paragraph ( https://www.youtube.com/watch?v=yguYdUgkyeI)
Part 2: 1 page (use attachment 1 for this)
– How does a health care administrator communicate with different audiences? What potential challenges might exist for health care administrators when engaged in communication with these audiences?
Health care administrators engage in communication with different audiences. Not surprisingly, the approaches used to effectively communicate with a patient or client may not be as effective when communicating with a physician, other medical staff, or non-medical employees/staff. While the approaches used to communicate with these different audiences will certainly vary, clear, concise, and direct messages will contribute to the effectiveness of your communication as a health care administrator.Review strategies in the resources for this week that health administrators might use to communicate with different audiences. Reflect on what strategies you might use as a health care administrator when engaged in communication with these audiences. Then, consider how these strategies might differ when delivering the same message to different audiences.
Donabedians framework for measuring healthcare quality comprises of a triad of domains: Structure, process and outcomes. Think about a recent health encounter you have had with a healthcare provider. Discuss how the visits quality was on each domain. What is your overall assessment of the providers quality? What recommendations would you make to improve quality?
Donabedians framework for measuring healthcare quality comprises of a triad of domains: Structure, process and outcomes. Think about a recent health encounter you have had with a healthcare provider. Discuss how the visits quality was on each domain. What is your overall assessment of the providers quality? What recommendations would you make to improve quality?
