Explains the concepts of diagnosis classification, care reimbursement,

Imagine you were appointed the Chief Financial Officer of your hospital, and you have a new crisis to confront. Your hospital received an unannounced visit from a CMS (Centers for Medicare and Medicaid Services) surveyor following a serious patient billing complaint. Your hospital is well-known both regionally and nationally for quality and safety, but the complaint threatens the hospital’s CMS enrollment, accreditation, and reputation. The surveyor determined that violations did occur, and the hospital has 90 days to resolve the issue or lose its Medicare funding. The violations include upcoding, duplicated and phantom charges, unbundling, and incorrect quantities.

You will create a plan for dealing with this crisis. The plan should consider current business processes, strategy, and communication processes to make the plan a reality. Also, consider how the crisis affects the staff and how you can reduce the amount of stress and pressure on them. Resolving the issue is just the beginning of the process. You need to determine if there was a process or system failure and figure out the solution to that failure. You should also develop a contingency plan for the future so the hospital will be prepared in the future for similar crisis events.

You need to explain the concepts of diagnosis classification, care reimbursement, and the billing system used in the hospital and by insurance companies for reimbursement for care received. You will explain how the hospital will meet patients’ needs, priorities, and expectations in a manner that exemplifies the values of respect, compassion, justice, and community pride. You need to explain the hazards of insurance, who pays for services, and the payment methods and plans available. Lastly, include the importance of proper medical billing and coding.

Instructions

Create either an audio recording or video recording at least 5 minutes in length to explain your planned proposal to deal with the violations and return the hospital into compliance within the 60 days given by CMS.

You will need to include:

  1. An explanation of concepts of diagnosis classification, care reimbursement, and the billing system used in the hospital and by insurance companies for reimbursement for care received.
  2. An explanation of how the hospital will meet patient’ needs, priorities and expectations in a manner that exemplifies the values of respect, compassion, justice, and community pride.
  3. Each of the violations upcoding, duplicated charges, phantom charges, unbundling, and incorrect quantities. Then, explain what will be done so these violations will not occur again.
  4. A contingency plan for the future so the hospital will be better prepared for similar crisis events.

Your work will be presented in an audio or video recording, as you will be submitting your presentation to this group of hospital employees, board members, and interested citizens and groups.

Options to record include (but are not limited to) your computer (PC or Mac), Screencastify which is a free add-on to Chrome, Zoom, or using an app of your choice on a smartphone or tablet.

Submit your recording link or file to the Dropbox along with your APA formatted references you used to support your oral presentation.

Requirements

Video:

  • Explains the concepts of diagnosis classification, care reimbursement, and the billing system used in the hospital and by insurance companies for reimbursement for care received.
  • Explains how the hospital will meet patients’ needs, priorities, and expectations in a manner that exemplifies the values of respect, compassion, justice, and community pride.
  • Addresses each of the violations upcoding, duplicated charges, phantom charges, unbundling, and incorrect quantities. Then explain what will be done so these violations will not occur again.
  • Develops a contingency plan for the future so the hospital will be better prepared for similar crisis events.
  • Is at least 5 minutes in length.

Select an article from a peer-reviewed  journal in your domain to analyze and annotate the claims.

Analyzing Claims

Select an article from a peer-reviewed  journal in your domain to analyze and annotate the claims. The article  should be academically reliable from within the last 5 years.  Adhere to APA Style when creating citations and references for this assignment. APA formatting, however, is not necessary.

How does this trade agreement impact doing business in this country?

Prior to beginning work on this discussion forum, please read Chapters 6 through 8 of the course textbook.

Visit the Free Trade Agreements (Links to an external site.) web page in the U.S. Department of Commerce website. Select a country from the list that is neither Mexico nor Canada, and provide a brief summary of the trade agreement. How does this trade agreement impact doing business in this country? How does it impact business in the US? Who profits the most from the trade agreement? Who profits the least? Why? Support your answer with at least one credible, recent source in addition to the course textbook. Your initial response should be 200 to 300 words.

Explain the theory of factor mobility

Prior to beginning work on this discussion forum, please read Chapters 6 through 8 of the course textbook.

Explain the theory of factor mobility. Consider this theory, and create a trade agreement between two to four countries that does not already exist (you can use the Free Trade Agreements (Links to an external site.) web page to review U.S. trade agreements). Explain why this agreement would be beneficial to each country and how the theory of factor mobility connects to this trade agreement. Support your answer with at least one credible, recent source in addition to the course textbook. Your initial response should be 200 to 300 words.

Other risks include corrupt practices, which are also heavily influenced by culture.

Use this discussion sample pdf  uploaded below as a guide when completing your own analysis.

Governments’ influence over trade and economies should not be underestimated. You may see some connections between culture and political ideologies, which can have positive and negative effects. Let’s dive into the political and legal environment for your project country. In this discussion, you will work on the following critical elements: Government and Ideologies, and Corruption.

Using The World Factbook and current news reports, identify the following elements of government:

  • Government type
  • Political leader(s)
  • Political pressure (or opposition) groups
  • Recent changes in governing rule

Other risks include corrupt practices, which are also heavily influenced by culture. Use Transparency International to identify three measures of corruption. Consider a review of the following:

  • Corruption Perceptions Index
  • Global Corruption Barometer
  • Global Corruption Report

Discuss what these political risks mean for businesses. What challenges or opportunities might an organization recognize with regard to the government and corrupt practices in the region? How can an organization protect against these risks and prepare management for issues they might face?

Teaching Effectiveness Measures

Teaching Effectiveness Measures

Before beginning work on this discussion forum, please review the link Doing Discussion Questions Right, the expanded grading rubric for the forum, and any specific instructions for this topic.

From the bullet point list below, select one topic for which you will lead the discussion in the forum this week. Early in the week, reserve your selected topic by posting your response (reservation post) to the Discussion Area, identifying your topic in the subject line. Be specific about your topic so that someone else could select the same bullet point but focus their post differently. By the due date assigned, research your topic and start a scholarly conversation as you respond with your initial or primary post to your own reservation post in the Discussion Area. Make sure your response does not duplicate your peers’ responses.

Topic:

  • What are some of the pros and cons of using teaching portfolios as a measure of teaching effectiveness?

Additionally, provide a brief paragraph describing your personal experience with completing teacher evaluation forms (student ratings forms) and how that experience impacted your understanding of the material this week.

As the beginning of a scholarly conversation, your initial post should be:

  • Succinct—no more than 500 words.
  • Provocative—use concepts and combinations of concepts from the readings to propose relationships, causes, and/or consequences that inspire others to engage (inquire, learn). In other words, take a scholarly stand.
  • Supported—scholarly conversations are more than opinions. Ideas, statements, and conclusions are supported by clear research and citations from course materials as well as other credible, peer-reviewed resources.