Dissertation

The following case study presents issues related to the legal rights afforded the accused and the reasons those rights are provided to all individuals under our system of criminal justice. Case Study:   John Doe is an individual who left his country in an effort to make a better life. However, he does not have […]

Traditionally, mental illness was considered a biological problem, either inherited or developed due to genetic vulnerability within the individual. This point of view is termed the medical model. Treatment was provided to the individual in one-to-one meetings with a psychiatrist or sessions with a psychotherapist. The field of mental health has evolved from the traditional […]

Discuss the resources needed to ensure billing and coding compliance with regulations and ethical standards. What would happen if these resources were not obtained? Describe the consequences of noncompliance with regulations and ethical standards.

Explain how new managed care contracts impact reimbursement for the healthcare organization. Support your explanation with concrete evidence or research.

Communicate the important role that each individual within this healthcare organization plays with regard to managed care contracts. Be sure to include the different individuals within the healthcare organization.

Analyze the strategies used to negotiate new managed care contracts. Support your analysis with research.

Develop a plan for periodic review of procedures to ensure compliance. Include explicit steps for this plan and the feasibility of enacting this plan within this organization.

Describe a way to structure your follow-up staff in terms of effectiveness. How can you ensure that this structure will be effective?

Organize the key areas of review in order of importance for timeliness and maximization of reimbursement from third-party payers. Explain your rationale on the order.

Analyze how third-party policies would be used when developing billing guidelines for patient financial services (PFS) personnel and administration when determining the payer mix for maximum reimbursement.