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Not really sure about all the requirements for HIPAA compliance? Review of presentation for a quick overview.
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· 7.4 Assignment: Comparing Between-subjects and Within-subjects Research Design or locate a published study that illustrates application of between and within subjects design. Explain the merits of each and the limitations of each (between and within). Indicate which you believe is more informative of the results. · Demonstrate understanding of the task and be able to address requirements using creativity and application of research design knowledge. · Must demonstrate ability to analyze existing research to compare strengths and limitations of between-subjects and within-subjects analysis. 1 Course Learning Outcomes for Unit I Upon completion of this unit, students should be able to: 1. Compare and contrast health services organizations within the healthcare system. 1.1 Explain the primary organizational components of the healthcare system and the commonalities and differences among health services organizations. Reading Assignment Chapter 2: Why and How Health Care Organizations Need to Change, pp. 13-34 Chapter 11: Leading Change: First Steps in Employing Strategic Intelligence to Get Results, pp. 259-310 Unit Lesson The Ideal Health System Imagine you are now the Secretary of Health and Human Services; you have a magic wand and you can create the perfect healthcare system. What components would it have? Would it include: 1. improving health outcomes for individuals, families and communities, 2. defending your population against threats to their health, 3. protecting your population against financial the consequences of bad health, 4. providing access to all with equality and no disparity, and 5. making it possible for people to make decisions in their own plans of care as well as have input into the decisions that affect your country’s overall health system? If you answered yes to these components, your definition matches the World Health Organization’s Components of a Healthcare System (2010). How This Course & Content Have Real-Word Application We are witness to history and are living in one of the most active times in our country’s history for healthcare reform. In 1966, the Medicare Act was signed into law by President Johnson, the most significant piece of healthcare legislation in our country to that point. Fast forward from 1966 to 2010 and the passing of the Affordable Care Act, which arguably is the second most impactful piece of legislation on U.S. health care since the Medicare Act. Medicare has grown significantly since 1966 and is now about 14% of our national budget, covering 47 million Americans (Kaiser Family Foundation, 2015). Government health plans (Medicare, Medicaid, Tri-Care, Veteran’s Administration) are growing and are on pace to insure more lives in the near future than lives covered by commercial plans (Cigna, United, Blue Cross, etc.) Speaking of this growth, Sylvia Burwell, Health & Human Secretary Director, announced that by 2018 the Centers for Medicar.
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Chapter 18 Private and Government Healthcare Systems Private and Government Healthcare Systems In the United States, health insurance coverage is generally classified as either private (non-government) coverage or government-sponsored coverage. Healthcare Coverage vs. Uninsured The National Center for Health Statistics defines health insurance as public and private payers who cover medical expenditures incurred by a defined population in a variety of settings. In the United States, the risk of becoming uninsured increases significantly for those earning low wages, the unemployed, and when employers are unable to provide insurance to workers. Table 5-2 presents the trend of declining health insurance coverage. Private Health Insurance The concept of insurance is to combine the healthcare experiences of many enrollees in order to reduce expenses for any one individual to a manageable prepayment amount. Employment-Based Plans is coverage offered through one’s own employment or a relative’s employment. It may be offered by an employer or by a union. Private Health Insurance Continued Direct-Purchase/Fee-For-Service Plans are the traditional type of healthcare policy. The physician sets a price for each type of service delivered, and then the client or insurance company pays the fee. This type of health insurance provides the most choices of doctors and hospitals. Private Health Insurance Continued The two kinds of fee-for-service coverage are basic and major medical. Basic covers some hospital services and supplies, such as X-rays and prescribed medicine. Major medical insurance covers the cost of long-term, high-cost illnesses or injuries plus whatever basic did not cover. Private Health Insurance Continued Group Contract Insurance—to make hospitals and physicians products and services affordable to ordinary people in the United States. With unmanaged care (fee-for-service) payments, healthcare providers could increase the number of single services they deliver in order to increase profit. Private Health Insurance Continued Managed Care—manages the cost and delivery of healthcare services, the quality of that healthcare, and access to care. Managed care influences how much healthcare clients can use. Health Maintenance Organizations (HMOs) are prepaid health plans. The goal of an HMO is to provide affordable, well-organized healthcare by allowing clients to prepay (capitation payment) on a regular monthly basis for all services provided. Private Health Insurance Continued Including physicians’ visits, hospital stays emergency care, surgery, laboratory (lab) tests, X-rays, and therapy for all members and their families. There may be a small co-payment for each office visit, such as $15 for a doctor’s visit or $50 for hospital emergency room treatment. Private Health Insurance Continued Point-of-Service Plans (POS) offer enrollees the option of receiving services from participating or nonparticipating prov ...
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Portia Grant is an employee who is paid monthly. For the month of January of the current year, she earned a total of $8,260. The FICA tax for social security is 6.2% of the first $118,500 earned each calendar year and the FICA tax rate for Medicare is 1.45% of all earnings. The FUTA tax rate of 0.6% and the SUTA tax rate of 5.4% are applied to the first $7,000 of an employee’s pay. The amount of federal income tax withheld from her earnings was $1,325.17. What is the total amount of taxes withheld from the Portia’s earnings? (Round your intermediate calculations to two decimal places.) A- $3,097.17 B- $2,443.21 C- $1,957.06 D- $1,722.00 E- $1,495.36 Solution The Answer is “C- $1,957.06” Total amount of taxes withheld from the Portia’s earnings = $1957.06 Total amount of taxes withheld = Federal Income Tax + FICA tax for social security + FICA tax rate for Medicare = $1,325.17 + [ $8,260 x 6.20%] + [$8,260 x 0.60%] = $1,325.17 + 512.12 + 119.77 = $1,957.06.
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Chapter 10 Privacy and Security of Health Records Learning Outcomes After completing this chapter, you should be able to: ♦ List HIPAA transactions and uniform identifiers ♦ Understand HIPAA privacy and security concepts ♦ Apply HIPAA privacy policy in a medical facility ♦ Discuss HIPAA security requirements and safeguards ♦ Follow security policy guidelines in a medical facility ♦ Explain electronic signatures Understanding HIPAA In Chapter 11 we will discuss various ways the Internet is being used for healthcare, including various implementations of EHR on the Internet, Internet-based personal health records (PHR), and remote access. In Chapter 12 we will explore the relationship of the EHR data to the determination of codes required for medical billing. Before moving to those topics it is prudent to understand HIPAA. HIPAA is an acronym for the Health Insurance Portability and Accountability Act, passed by Congress in 1996. The HIPAA law was intended to: ♦ Improve portability and continuity of health insurance coverage. ♦ Combat waste, fraud, and abuse in health insurance and healthcare delivery. ♦ Promote use of medical savings accounts ♦ Improve access to long-term care ♦ Simplify administration of health insurance HIPAA law regulates many things. However, a portion known as the Administrative Simplification Subsection1 of HIPAA covers entities such as health plans, clearinghouses, and healthcare providers. HIPAA refers to these as covered entities or a covered entity. This means a healthcare facility or health plan and all of its employees. If you work in the healthcare field, these regulations likely govern your job and behavior. Therefore, it is not uncommon for healthcare workers to use the acronym HIPAA when they actually mean only the Administrative Simplification Subsection of HIPAA. Note Covered Entity HIPAA documents refer to healthcare providers, plans, and clearing-houses as covered entities. In the context of this chapter, think of a covered entity as a healthcare organization and all of its employees. As someone who will work with patients’ health records, it is especially important for you to understand the regulations regarding privacy and security. However, let us begin with a quick review of HIPAA, then study the privacy and security portions in more depth. HIPAA implementation and enforcement is under the jurisdiction of several entities within the U.S. Department of Health and Human Services (HHS). This chapter will make extensive use of documents prepared by HHS. Administrative Simplification Subsection The Administrative Simplification Subsection has four distinct components: 1. Transactions and code sets 2. Uniform identifiers 3. Privacy 4. Security HIPAA Transactions and Code Sets The first section of the regulations to be implemented governed the electronic transfer of medical information for business purposes such as insurance claims, payme ...
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Sheena705
4 hours ago Amy Miller RE: Discussion - Week 7 Collapse NURS 6050C: Policy and Advocacy for Improving Population Health Main Question Post. The Patient Protection and Affordable Care Act of 2010 created several positive healthcare policies such as affordable health care, lifting the preexisting health condition clause from health insurance, requiring facilities to make healthcare charges public knowledge, and enforcing healthcare providers to become active in improving quality and health outcomes for patients (Library of Congress, n.d.). The act addressed a combination of the health care drivers of cost, quality, and access. According to a report released by the White House Press Secretary on April 17, 2014, “The Affordable Care Act is working. It is giving millions of middle class Americans the health care security they deserve, it is slowing the growth of health care costs and it has brought transparency and competition to the Health Insurance Marketplace.” (The White House, 2014). However, the price some healthcare providers had to pay a heavy financial - forcing some providers out of business. The negative side of the act is seldom portrayed in the news and media. Section 3131(a) of the act required payment for home health services to be rebased over a period of four years (Centers for Medicare & Medicaid Services, 2013); resultant in a 2.8% reduction beginning in 2014 for four consecutive years totaling a reduction in payment of 11.6%. The reductions were placed along with mandates for quality reporting, new forms, and new processes resulting in increased administrative overhead costs while shouldering the burden of financial reductions. Initiating a Change in Policy Process Living in a rural community, I witness firsthand the lack of access to care as there are limited numbers of primary care providers. Couple the limited access to providers with the amount of paperwork and forms that must be signed by a physician and patients are not referred to home health services as often as one should be – the result is the patient presenting to the emergency room or a hospitalization to have one’s health care needs met. Currently, Medicare and Medicaid do not allow physician assistants or advanced practice registered nurses (APRNs) to sign the necessary orders and plan of care for home health services – only a “doctor of medicine, osteopathy, or podiatric medicine” may sign for services (Government Publishing Office, 2014, p. 693). I would like to use the knowledge gained as an APRN to legislate for this mandate to be changed and allow both physician assistants and APRNs to sign for coverage of home health services. The Kingdon Model would be utilized for the legislation process by finding the three streams of problem, policy, and politics to coordinate with the above-mentioned issue (Milstead, 2019, p. 24). The problem would consist of the burdensome amount of paperwork imposed upon.
4 hours agoAmy MillerRE Discussion - Week 7CollapseNU.docx
4 hours agoAmy MillerRE Discussion - Week 7CollapseNU.docx
rhetttrevannion
Quick synopsis of how to coordinate HIPAA compliance training and specific information to include.
Hipaa compliance training
Hipaa compliance training
AnnaCutty
✍️
The Healthcare Common Procedure System (HCPCS)
The Healthcare Common Procedure System (HCPCS)
Nicole Wells
Similar to Hipaa101 updated
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4 hours agoAmy MillerRE Discussion - Week 7CollapseNU.docx
4 hours agoAmy MillerRE Discussion - Week 7CollapseNU.docx
Hipaa compliance training
Hipaa compliance training
The Healthcare Common Procedure System (HCPCS)
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Hipaa101 updated
1.
HIPAA: Understanding
the Basics
2.
Presenters Leanne Shank,
Esquire University Counsel Jennifer Kirkland, Esquire Office of University Counsel Washington and Lee University Lexington, Virginia
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