1. You work as an analyst for a medical clinic, and one of your tasks is to use

by | Sep 22, 2022 | Healthcare | 0 comments |

1. You work as an analyst for a medical clinic, and one of your tasks is to use health information to create reports that will give management more insight into how the clinic is operating as well as future threats and opportunities to the business. Discuss ways that you can use medical coding data to create meaningful reports for your management team.
Your journal entry must be at least 200 words in length. No references or citations are necessary.
2. The Centers for Medicare & Medicaid Services (CMS) are greatly involved in the Health care Common Procedure Coding System (HCPCS)/Current Procedural Coding (CPT). CMS’s involvement in improving coding guidelines influences many aspects of health care from the initial medical encounter through to reimbursement. In your opinion, how can improving procedural coding processes directly impact patients and providers? Do you, your family members, or close friends have any experience personally (as a patient) with complicated or confusing coding that you can reflect upon?
3. The health care industry continues to be a hot topic, primarily focusing on the increasing cost. The increasing cost of having access to health care is a burden that could impact many families across the nation. What are your feelings on this rising cost and what do you think can be done to foster a more cost-efficient health care model?
4. It is important for employees of health care providers to become familiar with their state’s health and human services programs in order to provide helpful information to patients. The Medicaid system is one of these programs with its operation differing from state to state. In what ways have you seen the Medicaid program impact your state and/or community? If you believe your state’s Medicaid program is not beneficial or cost effective, what suggestions would you give your state in order to enhance it?
5. It is important for employees of health care providers to become familiar with their state’s health and human services programs in order to provide helpful information to patients. The Medicaid system is one of these programs with its operation differing from state to state. In what ways have you seen the Medicaid program impact your state and/or community? If you believe your state’s Medicaid program is not beneficial or cost effective, what suggestions would you give your state in order to enhance it?
6. Submitting clean claims is an integral part of the medical practice. Falsifying claims can lead to penalties, delayed reimbursement, and, in some cases, legal consequences. Submitting erroneous or fraudulent claims is one of the more prevalent issues in the medical field. You have recently encountered the following scenario at your job. Explain how you would approach the situation, and keep in mind that there is no right or wrong answer, but please think critically about how this problem would be best handled.
You have been assigned to work with a physician who you do not normally work with while a medical assistant is away on vacation. During your daily chart review of the patients, you notice that many of the patients have been charged for procedures that were not performed and/or were unnecessary. You also notice that the medical assistant, who is also a close acquaintance of yours, who is working with this physician was the staff member who completed the charge ticket for the physician. (Please note: The physician has to sign every charge ticket as acknowledgment of services provided.)
Would you confront the physician, your friend/coworker, your manager, or remain silent? Explain your answer.
7. In today’s health care climate, it is imperative that patients be aware of the particulars of their insurance coverage. With the price of health care services rising, ensuring effective reimbursement procedures has never been more important. The explanation of benefits (EOB) focuses on providing patients with a breakdown of their medical bill and shows which entity is responsible for what charge. Explain a situation where a patient not being involved in their own health care reimbursement process can result in unwarranted charges. If you have any personal experiences where you, a friend, or a family member were inappropriately charged for a medical service, share that story, and explain how the issue was resolved.
8. Discuss how the concepts in this course can be applied to real-world situations and increase your chances of career or life success.
Your journal entry must be at least 200 words in length. No references or citations are necessary.

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