These individual steps are reviewing coding compliance, check billing compliance, and prepare and transmit claims. The reason these are related to compliance plans is because this information is required to be correct in order to be within compliance of the various laws. If there were something within these steps that was incorrect then it could result in problems with the patient’s care. Steps one through four are related to medical records. This is because these particular steps are the information that is entered into the patient’s semi-permanent medical record.
Evaluating Compliance Strategies HCR/220 February 24, 2013 Angela Colbert Evaluating Compliance Strategies This essay will evaluate the medical billing and coding compliance strategies. There are many mistakes that are made during the medical billing and coding process that could possibly be minimized with the proper strategies. In this paper the following questions will be addressed: What is the importance of correctly linking procedures and diagnoses? What are the implications of incorrect medical coding? How are medical coding, physician, and payer fees related to the compliance process?
The inpatient coder ensures that the data entered is relevant, indicating the reason that the patient was admitted, which involves the kind of illness and a breakdown of the treatment that was given (Henderson.) The inpatient coder uses the current version of ICD-CM classification for the most appropriate DRG assignment for assigning codes to diagnoses and procedures. They have to be able to determine the correct diagnosis and secondary diagnosis, identifying and assigning co-morbidities and complications and principle procedure codes. The inpatient coder is also responsible for selecting the proper DRG and Discharge Disposition Code. The impatient coder sends the documentation to HIM Operations for follow-up when Physicians documentation is not clear or straight forward.
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.
This will need to be corrected in order to be fully compliant with JC. The last section of this standard is to match these items that are to be available in the procedure area to the patient. This can be incorporated into the corrected for the previous standard section. Joint Commission Standard: UP.01.02.02: Mark the procedure site NCH has a substantive procedure on how and when to mark the procedure site; however it is not fully compliant. The hospital’s policy does follow JC while describing the situations requiring marking but does not require the person actually drawing the mark to be a physician.
State your understanding of the important considerations when releasing information to the various groups who may request patient information from a health facility. Each group must be discussed separately, giving the type of information that can be released and the procedure that must be followed when releasing information. Use the following Side headings: • Introduction on the importance of privacy and confidentiality of patient records Release of information to: • other health professionals • the patient • the patient’s family • solicitors, insurance companies, etc • Courts of law. Your report should be presented to business standards and be appropriate
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
According to American College of Medical Quality (2010), risk management involves identifying conditions that might put patients or a healthcare organization at the danger of undesirable outcome. In addition, the practice involves putting in place measures of avoiding, preventing, and controlling the risks. Quality management in healthcare organization is useful in managing, reducing, and alleviating risks. Risk management is an essential component of making sure that patients are safe, and that the care they get does not endanger their health or wellbeing. Process improvement is a quality management concept that involves the identification of weak areas in order to come up with ways to improve processes at the medical facility.
It provides statistics on volume as well as financial costs of such errors. It investigates the possible contributing factors that lead to medical errors. The report attempts to simplify steps that can be done in order to reduce errors and improve quality in healthcare. It concludes by providing information on approaches all ready being considered in order to fulfill the goal or reducing medical errors. The Institute of Medicine functions under a congressional organization through the National Academy of Sciences.
Ethical Issues of Chiropractor Enisse Woodall HCA 322: Health Care Ethics & Medical Law Instructor: Dolores Thomas Date: December 5, 2011 Ethical Issues of Chiropractor When it comes to the medical field and those who helps patients, different physician are capable of performing different task. Chiropractor are those who help people when their bones are stiffen, have sore muscle joints, and have body joint problems. This paper will discuss what a “chiropractor” is and what their duties are as a physician. The binding source of the legal source of this profession and also discuss the common ethical issues that “chiropractor” faces as a profession. Chiropractors “also known as doctors of chiropractic or chiropractic