Alycia Albers CTU Phase 4 IP Healing Hands Hospital’s Future Future Health care Trends Reform Realities:-Pay-for-performance systems are set to be implemented. IT upgrades:- better care delivery is accompanied by offering patients technology which supports that care. Involves the introduction of electronic medical records. It’s now shifting to ORs. Introducing patients to personalized medicine. Reform Realities-Pay-for-performance systems are set to be implemented meaning hospitals along with health systems will have to be more accountable than they have been. Every hospital facility has to come up with better strategies of tracking performance and the manner in which it provides its services. IT upgrades-making better care delivery is accompanied by offering patients technology which supports that care. This has already begun with the introduction of electronic medical records and it’s now shifting to hybrid ORs. Besides, hospitals have to introduce patients to personalized medicine such as using their smart phones in tracking their heart rate and sending the data to their care providers’ mobile devices (In Geisler, In Krabbendam & In Schuring, 2003). 2 Contd. Billing will shift to value from volume-in future. New payment mechanisms:-risk sharing, capitation agreement, bundling agreements. Health systems super-size- consolidation of various health care units. Billing will shift to value from volume-in future, healthcare systems will have to focus on high quality, improved outcomes, as well as, greater satisfaction. There will be new payment mechanisms which will include risk sharing along with capitation agreement, as well as, bundling agreements. Health systems super-size-it is projected that as a result of the lower costs, increased efficiencies and better quality; the hospitals, pharmaceutical suppliers, health systems and other participants within the health care are set to consolidate within the next decade. The resultant mega-sized entities are set to cause the end of stand-alone hospitals (Spekowius & Wendler, 2007). 3 Technologies Telemedicine-is expected to facilitate the delivery of cost effective health care in the coming future. This is due to the fact that technology is not only cheaper but also much easier to utilize. Electronic health data evolution- it is now possible to work with outside apps. The easy accessibility of medical data makes greater the knowledge depth. Telemedicine-is expected to facilitate the delivery of cost effective health care in the coming future. This is due to the fact that technology is not only cheaper but also much easier to utilize and various options are becoming available for every patient. Medical staff can connect with their patients through the internet by utilizing webcams. Electronic health data evolution-as health records become electronic, it is now possible to work with outside apps, which play a significant role in cap.

1. Alycia Albers
CTU
Phase 4 IP
Healing Hands Hospital’s Future
Future Health care Trends
Reform Realities:-Pay-for-performance systems are set to be
implemented.
IT upgrades:- better care delivery is accompanied by offering
patients technology which supports that care.
Involves the introduction of electronic medical records.
It’s now shifting to ORs.
Introducing patients to personalized medicine.

2. Reform Realities-Pay-for-performance systems are set to be
implemented meaning hospitals along with health systems will
have to be more accountable than they have been. Every
hospital facility has to come up with better strategies of
tracking performance and the manner in which it provides its
services.
IT upgrades-making better care delivery is accompanied by
offering patients technology which supports that care. This has
already begun with the introduction of electronic medical
records and it’s now shifting to hybrid ORs. Besides, hospitals
have to introduce patients to personalized medicine such as
using their smart phones in tracking their heart rate and sending
the data to their care providers’ mobile devices (In Geisler, In
Krabbendam & In Schuring, 2003).
2
Contd.
Billing will shift to value from volume-in future.
New payment mechanisms:-risk sharing, capitation agreement,
bundling agreements.
Health systems super-size- consolidation of various health care
units.

3. Billing will shift to value from volume-in future, healthcare
systems will have to focus on high quality, improved outcomes,
as well as, greater satisfaction. There will be new payment
mechanisms which will include risk sharing along with
capitation agreement, as well as, bundling agreements.
Health systems super-size-it is projected that as a result of the
lower costs, increased efficiencies and better quality; the
hospitals, pharmaceutical suppliers, health systems and other
participants within the health care are set to consolidate within
the next decade. The resultant mega-sized entities are set to
cause the end of stand-alone hospitals (Spekowius & Wendler,
2007).
3
Technologies
Telemedicine-is expected to facilitate the delivery of cost
effective health care in the coming future.
This is due to the fact that technology is not only cheaper but
also much easier to utilize.
Electronic health data evolution- it is now possible to work with
outside apps.
The easy accessibility of medical data makes greater the
knowledge depth.

4. Telemedicine-is expected to facilitate the delivery of cost
effective health care in the coming future. This is due to the
fact that technology is not only cheaper but also much easier to
utilize and various options are becoming available for every
patient. Medical staff can connect with their patients through
the internet by utilizing webcams.
Electronic health data evolution-as health records become
electronic, it is now possible to work with outside apps, which
play a significant role in capturing and recording more critical
data. Besides, the easy accessibility of medical data makes
greater the knowledge depth of not only the physicians but also
the medical staff (In Geisler, In Krabbendam & In Schuring,
2003).
4
Innovations
Data Analytics: better population health management-as data is
currently on a total mess.
This strategy tends to be poised to shift from pilot phase to the
sustainability phase.
Emotional sensing: comprehending the patients’ feelings- to
assist in understanding client’s point of views.
For instance, self-monitoring tools.

5. Data Analytics: better population health management-analytics
is whereby health care will have to invest in exploiting the
untapped potential as data is currently on a total mess. This
strategy tends to be poised to shift from pilot phase to the
sustainability phase in reference to the available research.
Emotional sensing: comprehending the patients’ feelings-newly
invented tools are set to assist caregivers in understanding their
client’s point of views thus enabling them to offer the
appropriate advice on how to lead health behaviors to the
clients. For instance, self-monitoring tools can inform the
patients that it will be necessary for them to change (Spekowius
& Wendler, 2007).
5
References
In Geisler, E., In Krabbendam, K., & In Schuring, R. (2003).
Technology, health care, and management in the hospital of the
future. Westport, CT: Praeger.
Spekowius, G., & Wendler, T. (2007). Advances in healthcare
technology: Shaping the future of medical care. Dordrecht:
Springer.

6. Running head: TRAINING MANUAL 1
TRAINING MANUAL 7
Training Manual
Alycia Albers
PHASE 4 BD
CTU
9/15/2014
The healthcare system
This is a not-for-profit health care system which has been
committed to provision of the patent care, teaching, research as
well as the desired care services to the community locally. The
institution has an innovative and quality care services to ensure
that it provides the desired service and ensure improved quality
as well as efficiency of the services (Nass, 2009). The main
aim of its existence is to cover the gap that is available in the
community and provide the kind of services that have not yet
been provided. It also intends to reach out and give cheaper
services to the low income people and even the people with
disabilities.
Organization structure
This health system is the organization whereby the medical

7. leaders get actively involves in the ways that it delivers the
healthcare to its communities. There is strong physician
participation at all the levels. As they partner with the nursing
department, it allows for the focus of best practices which are
intended to promote the superiors quality and services. The
institution physicians usually serve on Board of governors as
well as Board of Trustees and thus pretty much engaged in the
governance of the health system (Fordney, 2013). In the entire
organization, the operations are normally operated through the
joint administrative partnerships. In all functional area, there is
a manager which reports directly to higher management levels.
The process of checking patients in and out
In the healthcare system, there has been provided with the
patient check in-check out module which is meant to reduce the
time that should be taken to check the patients in and out. The
staff will be informed on all the important details of the patients
before they get to see the doctor. It is an electronic system
which first involves checking in through updating mini
registration (Wu & American Bar Association, 2007). For the
new patients, Patient Intake Form and practice management
software will auto-fill all the data that the patient has provided.
The second step will be to print 5 labels and then enroll the
particular patient for the care. Any outstanding bills as well as
missing documents will be identified. Then the patient is
supposed to report for their appointment. After seeing the
doctor, any new information will be updated on their profile.
The patient is then checked out after all services are provided.
Scheduling patients
The first thing will require arriving in advance of the time to do
everything that needs to be done before the arrival of the
patients. The next thing will be to determine the average time
that it takes for the doctor to see another patient together with
the time it takes to have the follow-up patient. The tests and
procedures will also be used to determine the time and that the
patients need to leave for home (Blesi & Kelley-Arney, 2012).
It should all be simple and also patient-centered.

8. Community and patient resources
The healthcare institution has been able to offer various
resources for the purpose of helping out its patients as well as
community and ensure that they are living well. For some of the
patient resources, the organization provides a high quality care
at a discounted fee particularly for the low-income and the
uninsured persons. There are clinics set at many places in the
community to ensure cover of the medical appointment, the
dental appointments and any urgent care (Fordney, 2013). In
addition, the organization frequently organizes health and
wellness events and provides the emergency preparedness
resources.
Process of interacting with patients
It is recommended that the CMAA staff should begin the
communication by greeting the patient. At that stage they are
required to make proper introduction of themselves, the job title
as well as the duties that will be related to their care. The staff
will be required to explain to the patients the whole process that
entails their care and enquire whether they are comfortable with
the process (Nass, 2009). All the patient queries will then be
solved and the staff will be expected to behave confidently as
well as professionally for the purpose of making the patients
feel at safe hands. Every staff member will be able to get a
procedure manual to guide anyone in performing the procedures
that they might not be sure about. Before any beginning, it is
advisable to check on the resident’s armband to avoid asking
the patient for their identity.
Health insurance plans
Along with the healthcare services that the institution has been
providing, it has partnered with insurance company to ensure
that it presents some insurance plans for patients together with
their families. Some of the areas that the organization provides
the health insurance plans on ranges from vision, medical,
dental insurance to life insurance (Keir & Keir, 2008). With its
partnership, the institution strives as hard as possible to ensure
that it has provided the most affordable options as well as the

9. personalized support which will ensure healthy and safety of the
patients. It is also within the duty of CMAA staff to make
proper verification of the patient’s insurance.
Financial procedures related to the policies of the organization
When a patient has arrived, it will be the duty of the CMAA
staff to ensure that the patient has completed to form all
necessary paperwork and then is supposed to input the newly
created financial record. The patient before being allowed to get
the physician service then should provide a receipt on payment
for the services which then will be updated on their account.
The CMAA should be able to specify the payment methodology
that has been used by the patient. The organization’s policy is
to ensure that every member of staff handling the patient’s
payment information has done so effectively. The organization
wants to ensure that all proper controls have been put in place
as well as utilized (Blesi & Kelley-Arney, 2012). The policy
requires the employees to specifically know who will be
handling certain monetary responsibilities. Employees need to
be familiar with the policies for handling any income, expense,
documentation, and payroll as well as the financial reporting
and statements.
Clean claims
It is among the many duties of the CMAA worker to ensure that
for the claims filled, they are clean claims. At the institution,
the main goal is mainly to process all the claims during the
initial submission and it should be complete claim for the
purpose of submission. The workers therefore are expected to
verify, file as well as keep all the transmission reports and make
use of the original claims forms only. The workers should
always avoid any folding of claims as much as possible. The
handwritten claims should never be submitted. Uppercase letters
should always be used and the claims are required to be printed
darkly (Rimmer, 2010).
Financial procedures
The financial procedures that are related to the institution’s
cash flow involve the payments made by the employees. The

10. post patient payments usually get recorded in the patient’s
accounts. This then should be followed by the follow-up claims.
The person in charge needs to determine any unpaid status of
the unpaid or any late payments mostly those from health
insurance. After the collection of the payment, the accounts
receivable will be debited on the organization’s account (Keir &
Keir, 2008). The cash flow is also significant in determining the
amount of cash that is needed to run the operations.
Billing policy and procedures
CMAA has the responsibility of ensuring that all the claims
have been submitted accordingly. They are required not to bill
the member until they have properly received the explanation of
benefit. Deposits should not be expected before covering all
services. The CMAA should be able to make payment for the
purpose of crediting all necessary accounts (Rimmer, 2010).
Protecting patients' privacy
As a healthcare worker, CMAA should be able to provide
necessary measures so that they can protect any patient
confidentiality at all times. The patients have the right of
authorizing the release of their health information (Nass, 2009).
For the purpose of maintaining the confidentiality, they should
be able to confirm the identity of the patient at their first
encounter. The patient’s case can never be discussed with
anyone else without the authorization of the patient. The hard
copies of the records should not be left in a place that an
unauthorized person might have an access to them.
Accounting and bookkeeping procedures and processes
Just like any other institution, this organization makes use of
book keeping for the purpose of tracking its business expenses.
The proper documentation clearly shows effective debiting as
well as the crediting procedures. The healthcare institution also
makes use of balance sheet to determine its financial position. It
also makes use of income statement to know the performance of
the business and determine what could be done. The
organization has an accounting system that should facilitate
recording, classification as well as the summary of the financial

11. records (Blesi & Kelley-Arney, 2012). The process should
involve review of transaction a period of time, proper entry, any
post transactions, confirmation of trial balance, then proper
adjustments and the preparation of the balance sheet together
with the income statement.
Office procedures for forms of documentation
Documentation should be realized to be the most important
procedure in the assigned work. There are five steps that the
employees are required to follow to ease on the pressure of
documentation. The first step requires assembling the proper
tools for the job. The next step is to track all the tasks for a
number of days. This is followed by documenting the most
important five procedures (Rimmer, 2010).After that it requires
identification of what is to be included in the procedure binder.
The last step is organizing the procedure binder.
HIPPA rules and regulations
HIPPA has been created with the efforts if protecting
individuals that are covered by health insurance and also setting
standards for storage as well as privacy of the personal medical
data. The HIPPA privacy rule has provided federal protections
for the personal health information that is held by physicians
and it also gives patients array of rights in respect to the
information (Fordney, 2013).
HIPPA forms
There are number of documentation and forms that are
HIPPA elated. These forms include first, the patient related
form which represents all the information about a certain patient
as well as any information that is useful in the organization. It
also includes the staff, volunteers as well as observer forms
which are meant to contain information that revolve around the
organizational staff and outside parties (Fordney, 2013).
Lastly, it includes the Data sharing, business as well as the
contracting forms.
Advance directives
These as used in the healthcare system are the living will
that allows one to document their wishes which concerns their

12. medical treatments come the end of life. The CMAA should
help individuals in making the right decisions for their will and
also determine whether they are in a good state of mind to make
the decisions (Rimmer, 2010).The emergency medical
technicians cannot and should not honor the living wills or the
powers of the attorney.
Medical record responsibilities
In the organization, it is recognized that every individual
is an individual that has unique healthcare needs as well as
wishes. Since the employees deal directly, they need to have
knowledge of the modern equipment, the ability of maintaining
records as well as files, interpersonal skills and even the ability
to maintain the patient confidentiality (Wu & American Bar
Association, 2007). Further, it is required that the employees
respond to all the requests for the medical records which might
involve processing letter as well as reports and also keeping the
supervisor informed on any problems and issues.
Obtaining patient demographics and their insurance information
The staff needs to be able to fill the patient demographic sheet
and ensure that all the basic demographic information has been
put into the sheet accurately. Should ensure it has information
on the; name, date of birth, doctor information, sex as well as
the social security number among others (Keir & Keir, 2008).
The patient’s insurance coverage should be verified way before
the services have been rendered. For any claim creation, the
process has to start with the entry of demographics and then
followed by the insurance verification.
Receive, triage and route phone calls
The CMAA should receive, triage as well as route to the
appropriate team members in all the incoming calls and place
the outgoing going calls. All calls should be answered the
soonest time possible and with a smile on the face. For triaging
calls, there will be a manual placed near every phone mainly for
reference (Nass, 2009). In routing the calls, it is advised that
the staff be aware of where the calls should be send.
Reviewing records for medical necessity

13. In order to address all the complaint claims, the CMAA will be
required to review the medical records of patients to establish
any additional documentation which could help prove the
medical necessity. It should provide an explanation to the
medical necessity and thus know the proper course of action
(Rimmer, 2010).The CMAA should be sure to make proper
reviews for the purpose of avoiding any errors in determining
the medical necessity. This will ensure that the payments have
been made solely for the services which meet the medical
necessity requirements.
Release of information guidelines
Standards have been set by HIPPA that every healthcare
institution should follow to safeguard the patient privacy as
well as confidentiality. Therefore, information regarding a
certain patient will only be released if it has been included in
hospital’s directory and when the patient has not made any
specifications that no information shall be released (Fordney,
2013). All the inquiries should identify the particular patient by
name, together with the information on the patient’s general
condition as well as information location of both the inpatient
and outpatient and will only be released when there is proof that
the inquiry has identified the patient by their name.
References
Blesi, M., Wise, B. A., & Kelley-Arney, C. (2012). Medical
assisting: Administrative and clinical competencies. Clifton
Park, NY: Delmar, Cengage Learning.
Fordney, M. T. (2013). Insurance handbook for the medical
office.
Keir, L., & Keir, L. (2008). Medical assisting: Administrative
and clinical competencies. Clifton Park, NY: Thomson Delmar
Learning.
Nass, S. J., Levit, L. A., Gostin, L. O., & Institute of Medicine
(U.S.). (2009). Beyond the HIPAA privacy rule: Enhancing
privacy, improving health through research. Washington, D.C:
National Academies Press.

14. Rimmer, M. M. (2010). Coding basics. Clifton Park, NY:
Delmar Pub.
Wu, S. S., & American Bar Association. (2007). Guide to
HIPAA security and the law. Chicago: ABA Section of Science
& Technology Law.