The first step would be to employ provider relations representatives. In most plans, there are people who are fully responsible for maintaining communications with the physicians and their office staff. Their job includes obtaining feedback from the physicians and office staff, updating them on changes, troubleshooting, maintaining and managing the contracts and other required documents, and to keep things running properly. This function is extremely important and the provider relations staff must be experienced. It is important for them to represent the physician’s point of view to plan management, but they should not side against the health plan unless they are truly at fault.
Quality Health Care in a Modern World Stephanie Jordan HCA 304 Instructor: Kori Novak October 15, 2011 Quality health care in today’s world consists of more than just a doctor or a nurse providing care to a patient; it is the combination of technology, management, training and the human aspect. The legal issues of providing the best health care are important because they involve not only protecting the patient but insuring that processes are put into place to change problem issues into stronger policies to protect the patient. Ethical issues come into play when a patient’s rights are violated or services are refused because of ability to pay. How do we build a strong community of health care? The first step is the role of the health
Risk Management Assessment Summary NAME HCS 451 Date INstructor Risk Management Assessment Summary It is important for a healthcare organization to promote and develop secure and successful patient care practices; the conservation of financial resources and the upholding of safe working environments are crucial to its name. Hospitals today face a wide range of risk factors that can determine success or failure, including: * Competitive responses both from other hospitals and physician groups. * Changes in government rules and regulations. * Razor-thin profit margins. * Community relations as expressed through zoning and permitting resistance.
If the consent is not given by a patient the practice, physician, or the healthcare worker can be held liable in a lawsuit. It is also important to show empathy and compassion to a patient to make them feel that they are welcomed. A healthcare worker should also know when to draw the line with a patient to avoid any kind of harassment issues or to make the patient feel uncomfortable. In any healthcare facility a patient’s need for care should be the main priority, and the healthcare worker should make sure that the priority is met. It has also been shown in the Medical Law and Ethics course that it is a must that all healthcare workers know and understand the legal
HIPPA ISSUE HIPPA Issues M230/HSC2641 Oct 13, 2013 Robert Feightner HIPPA Issues In the field of healthcare management we have a large responsibility to ensuring that hospital services and facilities are running smoothly and that patient’s health information are protected by upholding HIPPA standards and implementing them. This means that information is secure and private, and employees are properly trained and aware of these guidelines that are put out by HIPPA. If these standards are not supported and maintained than we could be in violation of HIPPA privacy rule and or security rule. The privacy rule regulates how patient health information (PHI) is being disclosed to third parties whether it is in electronic, paper or
The facility evaluates right and wrong and determines if the situation is compliant with the code of ethics (American Medical Association, 1995). Providing exceptional customer service ensures consumers are treated with dignity and respect. Health care facilities experience several ethical issues that require the facility to evaluate and determine the best outcome for everyone involved, it is important for Smithsonian employees adhere to the code of ethics policy and procedures (American Medical Association, 1995). Health care ethical consideration may consist of language barriers, informed consents, and religious beliefs are a few situations that may happen in health care. Smithsonian desire is for all patient to be well informed of his or her care plan.
The Role of Clinical Coding Physician documentation, Current Procedural Terminology (CPT) coding, and compliance with federal billing regulations are essential given the government's significant efforts to address fraud and abuse and the grave financial and legal consequences of noncompliance. From a compliance perspective, it is important that coders and physicians work collaboratively to ensure that the documentation supports what is coded. If trends identify documentation or coding problem areas, they should be used to educate both physicians and coders. The OIG has noted in its Compliance Program Guidance for Hospitals that “accurate coding depends upon the quality and completeness of the physician’s documentation.” “Active staff physician
UNDERSTANDING HOW OWN ROLE FIT WITHIN THE WIDER CONTEXT OF THE SECTOR 3.1 How Own Role Fits with the Delivery of the Service Provide The mission statement of my own work place is to observe and promote the principle of mutuality in the provision of healthcare. My Role to make fit in to the fulfilment of the mission includes a) Communicating promptly with the service user, other colleagues and my employer to coordinate care of patients as allowed by regulations. Information systems should be accessible and allow easy exchange of data in a confidential and responsible manner. b) Making sure patient’s advance directives are identified and utilized c) Assists patients and, where appropriate, encourages self care and self management of self-limiting conditions through good interaction d) Provide quality services in the most effective manner consistent with the best interest and convenience of the patient e) Help to maintain a unified, common, clear medical history and record of patient. 3.2 The Effect of Own Role on Service Provision The effect of my role in provision of health care service includes i.
The compiled data should be composed of specific measurements, input from employees as to suggestions for improvement and concerns as well as patient care results and input. The eminence and accessibility of the company’s resources must be evaluated first. Quality improvement (QI) measures the delivery of medical services and the outcomes like patient health status, mortality, and patient satisfaction (Hughes, 2012). Total Quality Management (TQM) is a model, which includes the organization’s management, staff working together as a team, outlines procedures, and policies, promotes methods of intellectual rational, and a modification to produce an atmosphere for excellence (Hughes, 2012). The construction of Continuous Quality Improvement (CQI) benefits the process of TQM; with the attitude that every chance an organization has should be an opening for improvement (Hughes,
The Code articulates the enduring values of medicine as a profession. As a statement of values to which physicians commit themselves individually and collectively, the code is a touchstone for medicine as a professional community. It defines medicine's integrity and the source if of the profession's authority to self- regulate. The code of Medical Ethics is a living document, evolving as changes in medicine and the delivery of health care raise new questions about how the profession's core values apply in physicians' day to day practice,. The Code links theory and practice, ethical principles and real world dilemmas in the care of patients.