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You are a corporate compliance officer for a hospital. You are also a feature writer for The Medical Reporter , an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects: How to conduct an investigation. It should include the following elements: Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity? Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved? Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation? Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview. Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated. How to develop a correction action plan. The plan may suggest: A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary. A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action. Assignment 1 Grading Criteria Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity. Explained the steps to take to determine who is involved in the complaint. Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation. Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview. Identified the criteria to determine if the allegations are substantiated or unsubstantiated. Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary. Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted. Written Components: Style: Tone, audience, and word choice Organization: Introduction, transitions, and conclusion Usage and Mechanics: Grammar, spelling, and sentence structure APA Elements: I.
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Assignment 1 LASA 2— Corporate ComplianceYou are a corporate comp.docx
Assignment 1: LASA 2— Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
.
Assignment 1 LASA 2— Corporate ComplianceYou are a corporate co.docx
Assignment 1: LASA 2—
Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
.
You are a corporate compliance officer for a hospital. You are also
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
By
the due date assigned
, deliver your assignment to the
Submissions Area.
Use the following file naming convention: LastnameFirstInitial_M5_A1.doc.
Assignment 1 Grading CriteriaMaximum Points
Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity.
-Explained the steps to take to determine who is involved in the complaint.32Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation.-
-Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview.-
-32Identified the criteria to determine if the allegations are substantiated or unsubstantiated.32Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary.
-Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted.
-Written Compon ...
Assignment 1 LASA 2— Corporate ComplianceYou are a corporate comp.docx
Assignment 1: LASA 2— Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
By
Monday, August 17, 2015
, deliver your assignment to the
M5: Assignment 1 Dropbox
.
Use the following file naming convention: LastnameFirstInitial_M5_A1.doc.
.
The Ultimate Guide to Choosing the Right Medical Billing Agency.pdf
In the ever-complex healthcare landscape, navigating the world of medical billing can be a daunting task. Reimbursement rates are constantly changing, insurance regulations are intricate, and ensuring accurate claim submissions is paramount for financial stability.
Hidden Risk Area: Grievances- Are you Prepared for a Survey?
PYA Consulting Manager Susan Thomas co-presented with Sheila Limmroth of DCH Health System on “Hidden Risk Area: Patient Grievances–Are You Prepared for a Survey?” Their presentation focused on the following objectives:
-Define CMS expectations for a patient grievance process and how to use the guidance as a compliance work plan auditing tool.
-Discuss what state auditors review when they come onsite to assess your patient grievance process.
-Consider the role of compliance in the patient grievance process.
HUS 335 Interpersonal Helping SkillsCase Assessment FormatT.docx
HUS 335: Interpersonal Helping Skills
Case Assessment Format
The case assessment takes place after the intake and assessment interviews have been conducted. The helping professional must evaluate the application for services to determine eligibility for services. This is just one process for conducting a case assessment.
Step 1. Provide me with your agency’s profile with your eligibility guidelines (on a separate page)
Step 2. Review the case assessment process (things to think about as you complete the assessment)
Step 3. Complete the Case Assessment (p. 2)
I. Examine your agency’s guidelines for eligibility as well as federal or state guidelines, if applicable. What are your agency’s guidelines for eligibility?
II. Review all the information you have gather on your client during the initial contact, intake, and assessment phases.
a. Applicant’s reason for applying for services
b. His/her background
c. Strengths
d. Weaknesses
e. The problem that is causing difficulty
f. What the applicants want to have happen as a result of service delivery
III. Determine if the client is eligible for services at your agency.
A. Is the client eligible for services? Why or why not?
B. What problems are identified (i.e., presenting problem)?
C. Are services or resources available that relate to the problems identified?
D. Will the agency’s involvement help the client reach the objectives goals that have been established.
E. Is more information needed (e.g., referral source, client’s family, chool officials, employer, medical doctor, mental health professional, previous social service agencies, etc.)
IV. Impressions
V. Assessment
VI. Service Identification/Recommendations for Services
VII. Case Assignment
Your Agency’s Name
Case Assessment
Pseudo Client Name: ____________________________________________ Date: _________________
Human Services Professional: ______________________________________ Title: _________________
Intake Date: ______________________ Assessment Interview Date: _________________________
I. Demographic description of client
Age, gender, cultural background, race, socioeconomic status, religion, occupation, marital/family status, education
II. Presenting Problem
Indicate referral source (e.g., self-referred or agency referral). If an agency referred the client, state why they referred the client to your agency.
State what brought the client to your agency from the client’s perspective. (This only needs to be a few sentences and not the history of the client.)
III. Impression/Interview affect, behavior, and mental status
How does the client appear to you (grooming, dress, voice, tone, mood, timeliness for the interview, cooperativeness, etc.)? Has this been consistent or changed throughout sessions (intake and assessment interview sessions)?
IV. History
Present the history as objectively as possible and only key information. Facts that were collected from the client, significant records, and referral source. Let the facts s ...
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Assignment 1 LASA 2— Corporate ComplianceYou are a corporate comp.docx
Assignment 1: LASA 2— Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
.
Assignment 1 LASA 2— Corporate ComplianceYou are a corporate co.docx
Assignment 1: LASA 2—
Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
.
You are a corporate compliance officer for a hospital. You are also
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
By
the due date assigned
, deliver your assignment to the
Submissions Area.
Use the following file naming convention: LastnameFirstInitial_M5_A1.doc.
Assignment 1 Grading CriteriaMaximum Points
Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity.
-Explained the steps to take to determine who is involved in the complaint.32Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation.-
-Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview.-
-32Identified the criteria to determine if the allegations are substantiated or unsubstantiated.32Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary.
-Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted.
-Written Compon ...
Assignment 1 LASA 2— Corporate ComplianceYou are a corporate comp.docx
Assignment 1: LASA 2— Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for
The Medical Reporter
, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
By
Monday, August 17, 2015
, deliver your assignment to the
M5: Assignment 1 Dropbox
.
Use the following file naming convention: LastnameFirstInitial_M5_A1.doc.
.
The Ultimate Guide to Choosing the Right Medical Billing Agency.pdf
In the ever-complex healthcare landscape, navigating the world of medical billing can be a daunting task. Reimbursement rates are constantly changing, insurance regulations are intricate, and ensuring accurate claim submissions is paramount for financial stability.
Hidden Risk Area: Grievances- Are you Prepared for a Survey?
PYA Consulting Manager Susan Thomas co-presented with Sheila Limmroth of DCH Health System on “Hidden Risk Area: Patient Grievances–Are You Prepared for a Survey?” Their presentation focused on the following objectives:
-Define CMS expectations for a patient grievance process and how to use the guidance as a compliance work plan auditing tool.
-Discuss what state auditors review when they come onsite to assess your patient grievance process.
-Consider the role of compliance in the patient grievance process.
HUS 335 Interpersonal Helping SkillsCase Assessment FormatT.docx
HUS 335: Interpersonal Helping Skills
Case Assessment Format
The case assessment takes place after the intake and assessment interviews have been conducted. The helping professional must evaluate the application for services to determine eligibility for services. This is just one process for conducting a case assessment.
Step 1. Provide me with your agency’s profile with your eligibility guidelines (on a separate page)
Step 2. Review the case assessment process (things to think about as you complete the assessment)
Step 3. Complete the Case Assessment (p. 2)
I. Examine your agency’s guidelines for eligibility as well as federal or state guidelines, if applicable. What are your agency’s guidelines for eligibility?
II. Review all the information you have gather on your client during the initial contact, intake, and assessment phases.
a. Applicant’s reason for applying for services
b. His/her background
c. Strengths
d. Weaknesses
e. The problem that is causing difficulty
f. What the applicants want to have happen as a result of service delivery
III. Determine if the client is eligible for services at your agency.
A. Is the client eligible for services? Why or why not?
B. What problems are identified (i.e., presenting problem)?
C. Are services or resources available that relate to the problems identified?
D. Will the agency’s involvement help the client reach the objectives goals that have been established.
E. Is more information needed (e.g., referral source, client’s family, chool officials, employer, medical doctor, mental health professional, previous social service agencies, etc.)
IV. Impressions
V. Assessment
VI. Service Identification/Recommendations for Services
VII. Case Assignment
Your Agency’s Name
Case Assessment
Pseudo Client Name: ____________________________________________ Date: _________________
Human Services Professional: ______________________________________ Title: _________________
Intake Date: ______________________ Assessment Interview Date: _________________________
I. Demographic description of client
Age, gender, cultural background, race, socioeconomic status, religion, occupation, marital/family status, education
II. Presenting Problem
Indicate referral source (e.g., self-referred or agency referral). If an agency referred the client, state why they referred the client to your agency.
State what brought the client to your agency from the client’s perspective. (This only needs to be a few sentences and not the history of the client.)
III. Impression/Interview affect, behavior, and mental status
How does the client appear to you (grooming, dress, voice, tone, mood, timeliness for the interview, cooperativeness, etc.)? Has this been consistent or changed throughout sessions (intake and assessment interview sessions)?
IV. History
Present the history as objectively as possible and only key information. Facts that were collected from the client, significant records, and referral source. Let the facts s ...
Prepare a workplace brief (8-10 double-spaced pages) to address a .docx
Prepare a workplace brief (8-10 double-spaced pages) to address a privacy breach that occurred in a health care organization. Include the consequences of failure to act and evidence-based recommendations for addressing the breach.
Introduction
Health care is one of the most heavily regulated major industries in the United States. Leaders are challenged to stay current and to comply with federal, state, and local laws and their associated regulations. Health care organizations are also responsible to meet industry standards. In some cases, payers equate meeting industry standards with achieving and maintaining accreditation. In fact, many payers consider accreditation a minimum condition of participation. In addition, individual licensure and certification requirements establish basic expectations for health care leaders' professional conduct.
In summary, health care leaders are responsible to:
1. Meet ethical personal, professional conduct, certification, and licensure expectations.
2. Comply with local, state, and federal health care and human resources laws.
3. Provide evidence of compliance with existing regulations and scan the field for emerging regulations.
4. Identify and meet appropriate accrediting body standards (for example, Joint Commission’s National Patient Safety Goals standards).
As an individual’s health care leadership career advances, so does the corresponding level of accountability. Not knowing the laws or regulations is not an excuse for not complying with them.
This assessment allows you to demonstrate your knowledge of and skills relating to compliance concepts, and governmental and regulatory agencies that oversee health care service delivery, billing, and general operations. You will also have the opportunity to apply the components necessary to initiate and maintain an effective compliance program. Finally, you will consider relevant human resources laws that may pertain to your compliance recommendations.
Instructions
In this assessment, you are assuming the role of an early careerist in risk management and quality improvement at one of Vila Health's community-based hospitals. Vila Health is a medium-sized system of health operating facilities in Minnesota and Wisconsin. You are working on a team-based initiative under the supervision of the Vila Health Chief Compliance Officer. Your role is to assist in addressing a specific compliance risk regarding a breach of privacy and a potential HIPAA violation. A Vila Health employee has disclosed—without prior written authorization—a patient's protected personal health information.
Here is the information the team has collected about the privacy breach and potential HIPAA violations to date. A Vila Health supervisor instructed an employee to obtain pre-authorization for an upcoming surgical procedure for a patient. The Vila Health employee submitted confidential, protected health care information about the patient to the insurance company. The Member Services Representati.
Case Study Analysis RubricNeeds DevelopmentFairGoodExcel.docx
Case Study Analysis Rubric
Needs Development
Fair
Good
Excellent
Introduction
Short introduction that does not cover the case scenario for the reader clearly, or missing introduction
0-2 points
Fair synopsis to introduce case – may need more details or be too lengthy.
3 points
Adequate synopsis to introduce case.
4 points
Brief, clear and succinct synopsis to introduce case.
5 points
Key Issues
Minimal to no detail covered for key issues.
0-2 points
Brief coverage on just one or a few key issues that need more thought and details.
3-6 points
Good succinct coverage of several key issues identified and explained.
7-9 points
Several strong points demonstrating critical thinking on several key issues covered succinctly.
10 points
Situation Analysis
Further details needed on the case situation.
0-4 points
Brief description of situation covered. Further analysis details needed.
5-9 points
Adequate case situation explained that also incorporates several areas of significance.
10-14 points
Detailed description summarizes the situation and covers probable causes and/or significant areas. Critical thinking is evident.
15 points
Organizational Strategy
Brief suggestion or two with impact of ideas on organizational strategy attempted.
0-4 points
Two short suggestions addressed to consider and some elements of organizational strategy impact covered. More details needed.
5-9 points
Elements of applicable organizational strategy covered for two suggestions that include pros/cons to consider and possible impact.
10-14 points
Elements of applicable organizational strategy to consider for three alternatives along with pros/cons and any possible ramifications of suggestions.
15 points
Implementation Plan
Further specifics and details needed on how to put suggestion(s) into place. Information may be brief or missing.
0-5 points
At least one feasible and realistic suggestion explained.
6-13 points
Several implementation suggestions covered in depth that incorporate some time elements to put ideas into place.
14-19 points
Detailed suggestions on how to implement recommendations that include time frames and possible contingency plan. Critical thinking demonstrated.
20 points
Benchmarks to Measure Success
Further details needed. Benchmark suggestions may be brief or missing.
0-4 points
Brief monitoring points are addressed to measure progress and success.
5-9 points
Some realistic monitoring plan suggestions are covered.
10-14 points
Monitoring and measure action plan suggestions show insight and are realistic to demonstrate critical thinking.
15 points
Scholarly Research of Literature
Required scholarly research of literature was not met. Some research attempt evident,and/or only text is referred to.
0-5 points
Credible outside research evident. Two scholarly research sources may not have been met.
6-13 points
Scholarly research for two recent peer-reviewed journal articles was met. Other credible outside research may be evident.
14-19 points
Scholarl ...
· Welcome to Week 4This week will cover material about Backgroun.docx
· Welcome to Week 4
This week will cover material about Background Checks.
In this lesson, we will discuss:
· What are communication strategies that can be used to communicate the regulatory changes to hiring leaders within an organization?
· Background Checks
· Education History
· Employment History
· Financial History
· Medical History
· Criminal History
· Social Media History
· Driving History
· Recordkeeping and Maintenance
Course Learning Objectives:
By the end of this lesson, you will be able to:
· Apply theory and concept to real world of HR policy and situations in the workplace
· Examine employee relations and discuss laws and policies related to employment opportunities, allegations of discrimination, employment practices, diversity, and affirmative action programs
· LESSON
Background Checks
LESSON TOPICS
· Background Checks
· Education History
· Employment History
· Financial History
· Medical History
· Criminal History
· Ban the Box
· Social Media History
· Driving History
· Background Check Summary
· Additional Resources on Background Checks
· Recordkeeping and Maintenance
· Communicating Policy
INTRODUCTION
This lesson will focus on two main areas. The first will be on background checks and the second will be on communicating policy changes to hiring managers within an organization. Although the two topics may seem unrelated, we will explore how they are connected. Anytime a policy is added, changed, or updated, the appropriate personnel must be informed. Communicating the new information in an effective way can be just as important as the policy itself.
Background Checks
Before we jump into our discussion on employment background checks, we need to understand what it means. Essentially, it means to verify or authenticate the information provided by an applicant or employee. This could include checking the information provided on an application, in a resume, or from an interview. The employer wants to ensure the employee or candidate has the background and experience they are claiming.
If it is determined that an applicant was untruthful about their experience, credentials, education, qualifications and so forth, then the employer can release, or fire that person provided the person signed or attested to the truthfulness of the information.
Information an employer might want to gather about an applicant could include some or all of the following; education history, work history, financial history, medical history with some exceptions), criminal history, and their use of social media. It is not against the law for an employer to ask questions about the applicant or employees background or to require a background check.
There are many reasons an employer would want to conduct a background check. The most common reason is to avoid negligent hiring. If an employee kills or injures someone, the company could be held liable. Some positions require it by law such as those that work with children, elderly, or the disabled. Recen ...
Individual ProjectFinancial Procedures in a Health Care Organiza.docx
Individual Project
Financial Procedures in a Health Care Organization
Wed, 7/26/17
2–3 pages; APA format, no errors. 100% turnitin check. NO Plagerism. On time.
healthinsurance companies provide the majority of the payment for medical services that clinics and physicians deliver. After the care has been delivered, the medical record is reviewed for completeness, codes are applied, and the billing office submits the claim to the insurance company or other third party payer for payment. There are several steps to take when submitting a claim form to the insurance company for reimbursement. The result of a clean claim is proper reimbursement for the services the facility has provided.
Discuss the following:
What does it mean to submit a clean claim?
List all of the information that is important before the claim can be submitted.
Discuss some of the reasons why a claim may be rejected.
State various reasons for the importance of a clean claim submission.
Address the consequences of not submitting a clean claim.
What steps should be taken to check the claim status?
As the practice manager, how would you ensure that the claims process results in clean claim submission and very few claim rejections.
.
Medical Management Internship Paper
Paper submitted to fulfill requirements for summer internship as part of my MHA degree program.
Dependent Verification: What You Don't Know Can Hurt You
Regardless of whether an employee’s intent is to defraud their employer, or whether the employee simply does not understand the plan rules, the time to correct an eligibility error is before a major health issue arises.
Be Appealing Revenue Cycle Management Series
Watch this Webinar to identify rejections, denials, and lost claims - Improve cash flow and your financial performance.
2hourhealthcarefraud
Sampling of training program material for health care fraud, abuse and compliance training for health care providers. contact Chiropractic Compliance Consultants for more at 913-369-9000, or visit our website at cccpfc.com
I need the follwoing assignmentThe project is the creation of a w.docx
I need the follwoing assignment:
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus.
Becker’s Hospital Review
has an excellent .
INTRODUCTIONThis graded project is a research paper that you’ll .docx
INTRODUCTION
This graded project is a research paper that you’ll complete
and submit to the school for grading. In your paper, you’ll
apply what you learned about HIPAA to an actual situation in
which a health care organization violated HIPAA regulations.
YOUR ASSIGNMENT
Health care organizations must know and follow the regulations
that are set forth by HIPAA, or be held accountable
for their failure to follow the rules. For this assignment,
you’ll need to find three real-life examples of HIPAA violations;
that is, violations of HIPAA’s privacy or security laws
that occurred in the United States since the passage of the
HIPAA law (after 1996). Each violation described should be
serious, and one that resulted in a fine or penalty for the
individual or company involved.
You can find real-life examples of HIPAA violations in
news reports, medical journals, professional health care
publications, and other similar reliable factual sources.
For each example violation, you should provide the following
information:
n A complete, descriptive summary of the case
n Important facts that relate to the case, such as the
names of the company or individual involved, the date
of the violation, and the city and state where the incident
occurred
n An explanation of the HIPAA rules that were violated
Be sure to answer these questions when writing your
summaries:
n How did the HIPAA violation occur?
n What policies (if any) did the organization have in place
to protect against the violation?
n What was the penalty for the violation (fine, prison term,
termination of employment, etc)?
Finally, describe three ways in which the organization could
have prevented the violation.
Organize your three case examples into a 750-word paper.
Research Instructions
To write your paper, you may use journal articles, textbook
material, case studies, and Web site information. The Web
site information must come from reputable and verifiable
sources, such as the United States Department of Health and
Human Services, the American Medical Association, professional
or business organizations, or articles published by
major news organizations.
To get started on finding a real-life case example that you’re
interested in, you can use an Internet search engine such as
Google. Try entering keywords such as “HIPAA violation”
under the “News” section. Or, go to your local library and
perform a search in the medical journals or professional
publications they have on file.
Writing Guidelines
1. Type your submission, double-spaced, in a standard
print font, size 12. Use a standard document format with
1-inch margins. (Do not use any fancy or cursive fonts.)
2. Read the assignment carefully, and follow the instructions.
3. Be sure to include the following information at the top of
your paper:
n Your name
n Your student number
n The course title (HIPAA Compliance)
n Graded project number (46081100)
n The date
4. Be specific. Limit your submission to the issues covered
by your chosen topic.
The s.
Healthcare ReimbursementI need help on the following assignment C.docx
Healthcare Reimbursement
I need help on the following assignment: Create a white paper. I have coompleted the first part and can provide it to you for help on the second part of the paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an i.
Most Common Clinical Research Site Worries and Complaints
All clinical research sites, especially new ones who’ve just entered the business, have a couple of common worries and complaints. The clinical research field is complicated and there are tons of formalities, papers, vendors, rules, regulations, etc. Taking into consideration the sensitivity of this business, the fact that human participants are involved, as well as the large amount of money that sponsors spend on a research, we have to work as professionally as possible.
There are many steps involved in a clinical trial, starting from the site selection visit, negotiations, then routine monitoring visits, subject enrollment and randomization, etc. All of these steps are equally important in order to conduct a successful trial. However, the complexity of the clinical research process usually worries and confuses new research sites. We’ve done a research on some of the most common site worries and complaints throughout the duration of a trial. Below, we’ll give you answers to all your questions.
Most Common Clinical Research Site Worries and Complaints
All clinical research sites, especially new ones who’ve just entered the business, have a couple of common worries and complaints. The clinical research field is complicated and there are tons of formalities, papers, vendors, rules, regulations, etc. Taking into consideration the sensitivity of this business, the fact that human participants are involved, as well as the large amount of money that sponsors spend on a research, we have to work as professionally as possible.
There are many steps involved in a clinical trial, starting from the site selection visit, negotiations, then routine monitoring visits, subject enrollment and randomization, etc. All of these steps are equally important in order to conduct a successful trial. However, the complexity of the clinical research process usually worries and confuses new research sites. We’ve done a research on some of the most common site worries and complaints throughout the duration of a trial. Below, we’ll give you answers to all your questions.
You are a special prosecutor for a Federal Task Force targeting orga.docx
You are a special prosecutor for a Federal Task Force targeting organized crime. The target suspects for the task force are slippery long-time organized crime figures. They have routinely escaped successful prosecution through their nefarious defense attorneys. To prepare new investigators assigned to the task force, you must caution them about mistakes that were made by previous task force members who were tripped up by the organized crime mouthpieces. Your task is to present legal issues that the defendants have used as loopholes in prior cases.
Acting as a special prosecutor for an organized crime task force, the student will present a 3–5 page white paper on new members coming on board as investigators in the task force. The issues related in the bullets below will be incorporated into the paper presented. There are a number of evidence-related resources that are not found in academic journals that may be utilized as references in this assignment. It is critical that when you make a statement of fact in your presentation, that you cite the reference you obtained the information from in the text of the paper and that the reference is included in your reference page. As always, your paper will be submitted in the APA format current edition. No abstract is required because this is a short position paper, but a title page, reference page, and appropriate running header with page numbers are necessary.
Describe at least two grounds for impeachment of a witness in a criminal trial and the ramifications of the impeachment for the case.
Articulate the meaning of hearsay. Explain how the Best Evidence Rule impacts hearsay prohibitions.
Explain at least two types of exceptions to the hearsay rule and why the court recognized their admissibility and truthfulness.
Detail at least two cautions about using privileged communications as evidence and the problems associated with doing so.
Compare and contrast the burdens of proof differences between a criminal and civil proceeding.
.
You are a newspaper reporter.Please interview the leader of one .docx
You are a newspaper reporter.
Please interview the leader of one of the great civilizations, any civilization or culture you choose. Ask that leader some questions -- for example, what is unique about this civilization? What are the challenges? What are the people's hopes for the future? What do you (or the leader) think will happen in the end with this civilization?
Then, write up your interview, with the leader's answers to your questions interspersed with your questions. Please include a description of the civilization or culture.
The interview should be written in newspaper style, about three pages long.
.
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Prepare a workplace brief (8-10 double-spaced pages) to address a privacy breach that occurred in a health care organization. Include the consequences of failure to act and evidence-based recommendations for addressing the breach.
Introduction
Health care is one of the most heavily regulated major industries in the United States. Leaders are challenged to stay current and to comply with federal, state, and local laws and their associated regulations. Health care organizations are also responsible to meet industry standards. In some cases, payers equate meeting industry standards with achieving and maintaining accreditation. In fact, many payers consider accreditation a minimum condition of participation. In addition, individual licensure and certification requirements establish basic expectations for health care leaders' professional conduct.
In summary, health care leaders are responsible to:
1. Meet ethical personal, professional conduct, certification, and licensure expectations.
2. Comply with local, state, and federal health care and human resources laws.
3. Provide evidence of compliance with existing regulations and scan the field for emerging regulations.
4. Identify and meet appropriate accrediting body standards (for example, Joint Commission’s National Patient Safety Goals standards).
As an individual’s health care leadership career advances, so does the corresponding level of accountability. Not knowing the laws or regulations is not an excuse for not complying with them.
This assessment allows you to demonstrate your knowledge of and skills relating to compliance concepts, and governmental and regulatory agencies that oversee health care service delivery, billing, and general operations. You will also have the opportunity to apply the components necessary to initiate and maintain an effective compliance program. Finally, you will consider relevant human resources laws that may pertain to your compliance recommendations.
Instructions
In this assessment, you are assuming the role of an early careerist in risk management and quality improvement at one of Vila Health's community-based hospitals. Vila Health is a medium-sized system of health operating facilities in Minnesota and Wisconsin. You are working on a team-based initiative under the supervision of the Vila Health Chief Compliance Officer. Your role is to assist in addressing a specific compliance risk regarding a breach of privacy and a potential HIPAA violation. A Vila Health employee has disclosed—without prior written authorization—a patient's protected personal health information.
Here is the information the team has collected about the privacy breach and potential HIPAA violations to date. A Vila Health supervisor instructed an employee to obtain pre-authorization for an upcoming surgical procedure for a patient. The Vila Health employee submitted confidential, protected health care information about the patient to the insurance company. The Member Services Representati.
Case Study Analysis RubricNeeds DevelopmentFairGoodExcel.docx
Case Study Analysis Rubric
Needs Development
Fair
Good
Excellent
Introduction
Short introduction that does not cover the case scenario for the reader clearly, or missing introduction
0-2 points
Fair synopsis to introduce case – may need more details or be too lengthy.
3 points
Adequate synopsis to introduce case.
4 points
Brief, clear and succinct synopsis to introduce case.
5 points
Key Issues
Minimal to no detail covered for key issues.
0-2 points
Brief coverage on just one or a few key issues that need more thought and details.
3-6 points
Good succinct coverage of several key issues identified and explained.
7-9 points
Several strong points demonstrating critical thinking on several key issues covered succinctly.
10 points
Situation Analysis
Further details needed on the case situation.
0-4 points
Brief description of situation covered. Further analysis details needed.
5-9 points
Adequate case situation explained that also incorporates several areas of significance.
10-14 points
Detailed description summarizes the situation and covers probable causes and/or significant areas. Critical thinking is evident.
15 points
Organizational Strategy
Brief suggestion or two with impact of ideas on organizational strategy attempted.
0-4 points
Two short suggestions addressed to consider and some elements of organizational strategy impact covered. More details needed.
5-9 points
Elements of applicable organizational strategy covered for two suggestions that include pros/cons to consider and possible impact.
10-14 points
Elements of applicable organizational strategy to consider for three alternatives along with pros/cons and any possible ramifications of suggestions.
15 points
Implementation Plan
Further specifics and details needed on how to put suggestion(s) into place. Information may be brief or missing.
0-5 points
At least one feasible and realistic suggestion explained.
6-13 points
Several implementation suggestions covered in depth that incorporate some time elements to put ideas into place.
14-19 points
Detailed suggestions on how to implement recommendations that include time frames and possible contingency plan. Critical thinking demonstrated.
20 points
Benchmarks to Measure Success
Further details needed. Benchmark suggestions may be brief or missing.
0-4 points
Brief monitoring points are addressed to measure progress and success.
5-9 points
Some realistic monitoring plan suggestions are covered.
10-14 points
Monitoring and measure action plan suggestions show insight and are realistic to demonstrate critical thinking.
15 points
Scholarly Research of Literature
Required scholarly research of literature was not met. Some research attempt evident,and/or only text is referred to.
0-5 points
Credible outside research evident. Two scholarly research sources may not have been met.
6-13 points
Scholarly research for two recent peer-reviewed journal articles was met. Other credible outside research may be evident.
14-19 points
Scholarl ...
· Welcome to Week 4This week will cover material about Backgroun.docx
· Welcome to Week 4
This week will cover material about Background Checks.
In this lesson, we will discuss:
· What are communication strategies that can be used to communicate the regulatory changes to hiring leaders within an organization?
· Background Checks
· Education History
· Employment History
· Financial History
· Medical History
· Criminal History
· Social Media History
· Driving History
· Recordkeeping and Maintenance
Course Learning Objectives:
By the end of this lesson, you will be able to:
· Apply theory and concept to real world of HR policy and situations in the workplace
· Examine employee relations and discuss laws and policies related to employment opportunities, allegations of discrimination, employment practices, diversity, and affirmative action programs
· LESSON
Background Checks
LESSON TOPICS
· Background Checks
· Education History
· Employment History
· Financial History
· Medical History
· Criminal History
· Ban the Box
· Social Media History
· Driving History
· Background Check Summary
· Additional Resources on Background Checks
· Recordkeeping and Maintenance
· Communicating Policy
INTRODUCTION
This lesson will focus on two main areas. The first will be on background checks and the second will be on communicating policy changes to hiring managers within an organization. Although the two topics may seem unrelated, we will explore how they are connected. Anytime a policy is added, changed, or updated, the appropriate personnel must be informed. Communicating the new information in an effective way can be just as important as the policy itself.
Background Checks
Before we jump into our discussion on employment background checks, we need to understand what it means. Essentially, it means to verify or authenticate the information provided by an applicant or employee. This could include checking the information provided on an application, in a resume, or from an interview. The employer wants to ensure the employee or candidate has the background and experience they are claiming.
If it is determined that an applicant was untruthful about their experience, credentials, education, qualifications and so forth, then the employer can release, or fire that person provided the person signed or attested to the truthfulness of the information.
Information an employer might want to gather about an applicant could include some or all of the following; education history, work history, financial history, medical history with some exceptions), criminal history, and their use of social media. It is not against the law for an employer to ask questions about the applicant or employees background or to require a background check.
There are many reasons an employer would want to conduct a background check. The most common reason is to avoid negligent hiring. If an employee kills or injures someone, the company could be held liable. Some positions require it by law such as those that work with children, elderly, or the disabled. Recen ...
Individual ProjectFinancial Procedures in a Health Care Organiza.docx
Individual Project
Financial Procedures in a Health Care Organization
Wed, 7/26/17
2–3 pages; APA format, no errors. 100% turnitin check. NO Plagerism. On time.
healthinsurance companies provide the majority of the payment for medical services that clinics and physicians deliver. After the care has been delivered, the medical record is reviewed for completeness, codes are applied, and the billing office submits the claim to the insurance company or other third party payer for payment. There are several steps to take when submitting a claim form to the insurance company for reimbursement. The result of a clean claim is proper reimbursement for the services the facility has provided.
Discuss the following:
What does it mean to submit a clean claim?
List all of the information that is important before the claim can be submitted.
Discuss some of the reasons why a claim may be rejected.
State various reasons for the importance of a clean claim submission.
Address the consequences of not submitting a clean claim.
What steps should be taken to check the claim status?
As the practice manager, how would you ensure that the claims process results in clean claim submission and very few claim rejections.
.
Medical Management Internship Paper
Paper submitted to fulfill requirements for summer internship as part of my MHA degree program.
Dependent Verification: What You Don't Know Can Hurt You
Regardless of whether an employee’s intent is to defraud their employer, or whether the employee simply does not understand the plan rules, the time to correct an eligibility error is before a major health issue arises.
Be Appealing Revenue Cycle Management Series
Watch this Webinar to identify rejections, denials, and lost claims - Improve cash flow and your financial performance.
2hourhealthcarefraud
Sampling of training program material for health care fraud, abuse and compliance training for health care providers. contact Chiropractic Compliance Consultants for more at 913-369-9000, or visit our website at cccpfc.com
I need the follwoing assignmentThe project is the creation of a w.docx
I need the follwoing assignment:
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus.
Becker’s Hospital Review
has an excellent .
INTRODUCTIONThis graded project is a research paper that you’ll .docx
INTRODUCTION
This graded project is a research paper that you’ll complete
and submit to the school for grading. In your paper, you’ll
apply what you learned about HIPAA to an actual situation in
which a health care organization violated HIPAA regulations.
YOUR ASSIGNMENT
Health care organizations must know and follow the regulations
that are set forth by HIPAA, or be held accountable
for their failure to follow the rules. For this assignment,
you’ll need to find three real-life examples of HIPAA violations;
that is, violations of HIPAA’s privacy or security laws
that occurred in the United States since the passage of the
HIPAA law (after 1996). Each violation described should be
serious, and one that resulted in a fine or penalty for the
individual or company involved.
You can find real-life examples of HIPAA violations in
news reports, medical journals, professional health care
publications, and other similar reliable factual sources.
For each example violation, you should provide the following
information:
n A complete, descriptive summary of the case
n Important facts that relate to the case, such as the
names of the company or individual involved, the date
of the violation, and the city and state where the incident
occurred
n An explanation of the HIPAA rules that were violated
Be sure to answer these questions when writing your
summaries:
n How did the HIPAA violation occur?
n What policies (if any) did the organization have in place
to protect against the violation?
n What was the penalty for the violation (fine, prison term,
termination of employment, etc)?
Finally, describe three ways in which the organization could
have prevented the violation.
Organize your three case examples into a 750-word paper.
Research Instructions
To write your paper, you may use journal articles, textbook
material, case studies, and Web site information. The Web
site information must come from reputable and verifiable
sources, such as the United States Department of Health and
Human Services, the American Medical Association, professional
or business organizations, or articles published by
major news organizations.
To get started on finding a real-life case example that you’re
interested in, you can use an Internet search engine such as
Google. Try entering keywords such as “HIPAA violation”
under the “News” section. Or, go to your local library and
perform a search in the medical journals or professional
publications they have on file.
Writing Guidelines
1. Type your submission, double-spaced, in a standard
print font, size 12. Use a standard document format with
1-inch margins. (Do not use any fancy or cursive fonts.)
2. Read the assignment carefully, and follow the instructions.
3. Be sure to include the following information at the top of
your paper:
n Your name
n Your student number
n The course title (HIPAA Compliance)
n Graded project number (46081100)
n The date
4. Be specific. Limit your submission to the issues covered
by your chosen topic.
The s.
Healthcare ReimbursementI need help on the following assignment C.docx
Healthcare Reimbursement
I need help on the following assignment: Create a white paper. I have coompleted the first part and can provide it to you for help on the second part of the paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an i.
Most Common Clinical Research Site Worries and Complaints
All clinical research sites, especially new ones who’ve just entered the business, have a couple of common worries and complaints. The clinical research field is complicated and there are tons of formalities, papers, vendors, rules, regulations, etc. Taking into consideration the sensitivity of this business, the fact that human participants are involved, as well as the large amount of money that sponsors spend on a research, we have to work as professionally as possible.
There are many steps involved in a clinical trial, starting from the site selection visit, negotiations, then routine monitoring visits, subject enrollment and randomization, etc. All of these steps are equally important in order to conduct a successful trial. However, the complexity of the clinical research process usually worries and confuses new research sites. We’ve done a research on some of the most common site worries and complaints throughout the duration of a trial. Below, we’ll give you answers to all your questions.
Most Common Clinical Research Site Worries and Complaints
All clinical research sites, especially new ones who’ve just entered the business, have a couple of common worries and complaints. The clinical research field is complicated and there are tons of formalities, papers, vendors, rules, regulations, etc. Taking into consideration the sensitivity of this business, the fact that human participants are involved, as well as the large amount of money that sponsors spend on a research, we have to work as professionally as possible.
There are many steps involved in a clinical trial, starting from the site selection visit, negotiations, then routine monitoring visits, subject enrollment and randomization, etc. All of these steps are equally important in order to conduct a successful trial. However, the complexity of the clinical research process usually worries and confuses new research sites. We’ve done a research on some of the most common site worries and complaints throughout the duration of a trial. Below, we’ll give you answers to all your questions.
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You are a special prosecutor for a Federal Task Force targeting organized crime. The target suspects for the task force are slippery long-time organized crime figures. They have routinely escaped successful prosecution through their nefarious defense attorneys. To prepare new investigators assigned to the task force, you must caution them about mistakes that were made by previous task force members who were tripped up by the organized crime mouthpieces. Your task is to present legal issues that the defendants have used as loopholes in prior cases.
Acting as a special prosecutor for an organized crime task force, the student will present a 3–5 page white paper on new members coming on board as investigators in the task force. The issues related in the bullets below will be incorporated into the paper presented. There are a number of evidence-related resources that are not found in academic journals that may be utilized as references in this assignment. It is critical that when you make a statement of fact in your presentation, that you cite the reference you obtained the information from in the text of the paper and that the reference is included in your reference page. As always, your paper will be submitted in the APA format current edition. No abstract is required because this is a short position paper, but a title page, reference page, and appropriate running header with page numbers are necessary.
Describe at least two grounds for impeachment of a witness in a criminal trial and the ramifications of the impeachment for the case.
Articulate the meaning of hearsay. Explain how the Best Evidence Rule impacts hearsay prohibitions.
Explain at least two types of exceptions to the hearsay rule and why the court recognized their admissibility and truthfulness.
Detail at least two cautions about using privileged communications as evidence and the problems associated with doing so.
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You are a newspaper reporter.Please interview the leader of one .docx
You are a newspaper reporter.
Please interview the leader of one of the great civilizations, any civilization or culture you choose. Ask that leader some questions -- for example, what is unique about this civilization? What are the challenges? What are the people's hopes for the future? What do you (or the leader) think will happen in the end with this civilization?
Then, write up your interview, with the leader's answers to your questions interspersed with your questions. Please include a description of the civilization or culture.
The interview should be written in newspaper style, about three pages long.
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You are a police officer assigned to a task force that is investigat.docx
You are a police officer assigned to a task force that is investigating major drug trafficking operations in your jurisdiction. As part of the investigative process, a judge has issued a wiretap order for a suspect’s phone. You are assigned the responsibility of monitoring phone conversations, and you overhear the suspect as well as other individuals who may or may not be involved in the drug ring. Before obtaining enough evidence to arrest and prosecute the suspect, you hear evidence related to other types of criminal activity.
Assignment Guidelines
Address the following in 900–1,200 words:
What constitutional issues are involved in the scenario that dictates what you can and cannot do related to the evidence of other criminal activity outside the scope of the original wiretap order? Explain.
If you arrest the other individuals for the crimes not associated with the reasons for the wiretap, what happens to any future evidence that might be obtained from the wiretap? Why?
If you fail to arrest the other individuals, are there any potential risks involved? Explain you answer.
Be sure to reference all sources using APA style.
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You are a teaching assistant for an undergraduate history class and .docx
You are a teaching assistant for an undergraduate history class and need to prepare a test. You want evidence to show that students know the material well. What kind of test would you prepare? What kind of test do you think requires the most in-depth knowledge? Why?
As Dan took his history test, he could not recollect many of the dates he had studied. Dan had memorized some important dates just before the test. While he was doing this, he was also talking on the phone. Which of Dan's memory stores—sensory memory, short-term memory (STM), or long-term memory (LTM)—do you think were most affected by his phone conversation? Why? Could Dan have done something differently to prevent forgetting the dates? Explain.
Identify two different kinds of mnemonic devices that could help Dan remember dates for his history test. Explain how they could be used.
Melissa is disappointed that she received yet another “D” on a test. She studied for several hours by reading and rereading her textbook and class notes. Based on the levels-of-processing memory theory, explain why Melissa’s method of studying was not very effective? What could she have done differently?
Using Baddeley’s working memory model, give an example of two tasks that could successfully be performed simultaneously (For example, can you listen to music while studying at the same time?). Discuss two other tasks that probably would interfere with each other. Make sure to discuss your answers in terms of the visuospatial scratchpad, the phonological loop, and the central executive.
Write your initial response in 4–5 paragraphs. Apply APA standards to citation of sources.
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You are a manager and leader in a diverse organization that includes.docx
You are a manager and leader in a diverse organization that includes locations in many other countries. You are asked to create a presentation to share your experiences regarding leadership
Create
an 8- to 10-slide Microsoft
®
PowerPoint
®
presentation including detailed speaker notes. The presentation should include the following:
The role gender plays in leadership including the effect it has on in global organizations
The role of leadership style on leadership effectiveness
The influence of the culture on leading an organization
The potential challenges in leading an organization that is global
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You are a fourth-grade teacher who has a very diverse class. In your.docx
You are a fourth-grade teacher who has a very diverse class. In your class, there are two students with ADHD, one English language learner, and three students who are below grade level in the content area of your lesson plan.
Your class is a mix of auditory, visual, and kinesthetic learners.
You may use a lesson plan from the Internet, but cite all sources appropriately.
Revise
the lesson plan to include differentiated instruction.
Include
the following in your lesson plan:
Content area
Grade level
Content standard
Learning objective
Strategies and best practices for each student who needs differentiated instruction
Strategies to meet the needs of all learning styles
Cite
all sources according to APA guidelines.
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You are a geriatric case manager and you are working with Chuck an 82 year old man who currently lives in a two bedroom single family home. Chuck’s wife died five years ago. They never had any children.
On your first visit to the house you find the exterior in disrepair and a lawn that is several weeks overdue for a mowing. Chuck tells you he usually mows the lawn himself but the last 4 weeks he has been experiencing too much pain in his left ankle which is swollen. His clothes are stained and disheveled but it does appear he is bathing regularly.
Inside the house you find boxes and boxes of “stuff” in every room. The hallway is piled with boxes on one side restricting the width of the hallway all the way down to his bedroom. There is a small path between the boxes and his bed that allows him access to the bed. The second bedroom is filled with boxes and miscellaneous items strewn about. You can’t see the floor. The bathroom doesn’t look as if it has been cleaned for months.
The kitchen counters are cluttered with dirty dishes and old empty fast food bags, containers, pizza boxes and a roach here and there. The refrigerator is almost empty and the floor is filthy. You look outside the back door and see that he does manage to take the garbage out of the house from time to time but the patio is filled with large bags of garbage that were never put out for pick up. Although the living room doesn’t have any boxes in it the furniture except for one chair is piled high with clutter.
You make arrangements to revisit Chuck the following week and at that time provide him with an plan to engage some services to help him get the house in order as well as get him in to see a doctor. Chuck insists he doesn’t need help with anything and that he is perfectly fine living like he is. He states he isn’t hurting anyone and asks that you please leave him alone.
Discuss whether you believe Chuck to be mentally competent, whether or not this is a case of self-neglect and how you would proceed.
Support your statements with evidence from the Required Studies and your research. Cite and reference your sources in APA style.
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You are a county supervisor of elections and have been tasked to dev.docx
You are a county supervisor of elections and have been tasked to develop a policy to increase voter turnout. Prepare an 8–10 slide Powerpoint presentation of your proposed policy.
Prepatre with a short introduction.
What do other "democratic" countries do to encourage voter participation?
cite references
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You are a new administrator for Contoso, Ltd., working on a test dep.docx
You are a new administrator for Contoso, Ltd., working on a test deployment of the application server technologies included with Windows Server 2008. In this lab, you explore some of the high-availability features included with Windows Server 2008.
LAB CHALLENGE 12.1: CREATING A TERMINAL SERVICES SERVER FARM
Contoso, Ltd. plans to deploy many new workstations using terminal servers to host applications for them. Because multiple terminal servers are needed, your department is exploring the construction of a Windows Server 2008 terminal server farm, consisting of multiple computers balancing the client load between them.
To complete this challenge, you must install and configure Terminal Services on your server and your partner server to create a terminal server farm called FARM##, where ## is the number assigned to the server running the TS Session Broker role service. Use DNS round robin to balance the incoming traffic load between the two servers.
Connect to the server farm using the Remote Desktop Connection client, and use the Terminal Services Manager console to monitor the activity on the server farm.
Document your procedures by listing all of the tasks you completed during installation and configuration. Take screen shots of the Terminal Services Configuration, Terminal Services Manager, and DNS Manager consoles illustrating all of the completed tasks.
When you are finished, remove all of the roles and features you installed on both computers before you proceed to the next exercise.
LAB CHALLENGE 12.2: CREATING A FAILOVER CLUSTER
After suffering a serious server outage, Contoso, Ltd. decided to implement its business-critical applications using failover clusters. You must create a test deployment of a two-node failover cluster on your lab network. To complete this challenge, install the Failover Clustering feature, and use it to validate, create, and configure a failover cluster using your server and your partner server. Give the failover cluster the name Cluster##, where ## is the number assigned to the server on which you created the cluster.
After you complete the configuration process, demonstrate the cluster’s functionality by monitoring the cluster on your server as you move the cluster##other application from one server to the other.
Document your procedures by listing all of the completed installation and configuration tasks. Save the Failover Cluster Validation Report to your Documents folder. Take screen shots of the Failover Cluster Management console illustrating the completed tasks and the cluster’s functionality.
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Yo no ___________a la universidad los viernes porque no ________.docx
Yo no ___________a la universidad los viernes porque no _________clases.
¿Tú ____________la dirección de Julio? Él no ____________a clase los lunes.
Nosotros __________a la biblioteca con Amanda porque no ____________auto.
Rogelio _____________a las ocho y ellos ___________a las diez.
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xercise 4-15The following are the major balance sheet classificati.docx
xercise 4-15
The following are the major balance sheet classifications.
Current assets
Current liabilities
Long-term investments
Long-term liabilities
Property, plant, and equipment
Stockholders’ equity
Intangible assets
Classify each of the following accounts taken from Geraldo Company’s balance sheet.
Balance Sheet Classification
Accounts
Accounts payable
Accounts receivable
Cash
Common Stock
Patents
Salaries and wages payable
Inventory
Investments
Accumulated depreciation
Buildings
Land
Long-term debt
Supplies
Equipment
Prepaid expenses
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xamine the economic impact of border protection.1) What actions p.docx
xamine the economic impact of border protection.
1) What actions prompted the
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2) Who is the enemy? From what or whom are we protecting the border? Is the enemy more than terrorism and terrorists?
3) What is the connection between border enforcement and public health and Safety concerns?
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Written Portion of the Case SummaryTwo pages in length total maxim.docx
Written Portion of the Case Summary
Two pages in length total maximum (APA format - 12 font, double spaced).
Page 1 –
mandatory section headings
·
Introduction/Summary of Case
·
Issue(s)/Motivation
·
Fundamental Technology(s) Involved
·
Various Alternatives or Implementations or Comparison of the Technology(s)
·
Critique/Evaluation of the Alternatives or Implementations of the Technology(s) Involved
·
Future of the Technology(s)
Page 2 –- List and answer only the “CASE STUDY QUESTIONS” posed by authors
1.
What types of companies are most likely to adopt cloud-based CRM software services? Why? What companies might not be well-suited for this type of software?
2.
What are the advantages and disadvantages of using cloud-based enterprise application?
3.
What people, organization, and technology issues should be addressed in deciding whether to use a conventional CRM system versus a cloud-based version?
Text:
Management Information Systems: Managing the Digital Firm; Thirteenth Edition; Kenneth C. Laudon and Jane P. Laudon; Pearson Education, Upper Saddle river, NJ, 07458; 2014; ISBN 13:978-0-13-305069-1
.
You are a community health educator and you have been tasked with de.docx
You are a community health educator and you have been tasked with developing a presentation to be given in a setting to educate an audience on one specific kind of diabetes.
Identify
your audience. Examples include the following:
Senior center
Middle school
A Workplace
Create
a resource (350 to 700 words) as a way to share this information. Examples include the following:
A social media page
An information pamphlet
A presentation
Consider
the best method so it is crafted in an appropriate and understandable way for your identified audience.
Choose
from the two following options, which kind of diabetes you'll be reporting on:
Option A: Type I
How society views diabetes (what society thinks it is versus what it actually is, common beliefs and practices)
Signs and symptoms
Compliance with treatment regimens
Impact on health care resources
Option B: Type II
How society views diabetes (what society thinks it is versus what it actually is)
Preventive measures
Making the right decisions to live a healthy life
Compliance with common beliefs
Impact on health care resources
Click
the Assignment Files tab to submit your assignment.
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You are a citizen of a developing country. The year is 2025 and your.docx
You are a citizen of a developing country. The year is 2025 and your country is facing massive population growth. In the last decade alone, it has seen a population growth of nearly 200 million people, and demographics forecast continued rapid growth well into the next generation.
The nation has also seen a rapid rise in industrial and commercial development, both of which are wreaking havoc on the environment. Climatologists have noted a marked increase in the levels of air and water pollution. In addition, the nation's reliance on mono-crops has made it food-dependent on its trading partners; it can no longer feed its growing population on its own. This has resulted in some food shortages.
The most promising option the state has at present is to try to stem the tide of population growth internally.
Demographers have noted that, primarily due to a tradition of raising large families and other cultural and religious mandates, most of the state's population growth is occurring among poorer, rural sectors. Many families are comprised of up to ten children each. In some instances, birth control is available, but simply not used. In other instances, no birth control or formal family planning education is provided. The affordability of contraception is also a concern.
Culturally, however, it has been found to be taboo to discuss family concerns publicly. Yet the state knows that it is facing an impending food, environmental, political and even international crisis if something is not done immediately.
.
Written Communication SkillsDueDec 07, 1159 PMNot Submi.docx
Written Communication Skills
Due
Dec 07, 11:59 PM
Not Submitted
POINTS
4
Paper
Objectives:
View more
»
Expand view
Instructions
Assignment Files
Grading
Create,
from your example of poor customer service in your class discussion in Week 1, a 700- to 1050- word letter of complaint.
Address
, in the letter:
the original problem.
the customer service representative's behavior regarding the situation.
the resolution you hope to achieve.
.
XML provides a method for data to be transferred between systems. Sp.docx
XML provides a method for data to be transferred between systems. Specify at least three components of an XML document. Analyze how each component ensures data reliability and validation.
Identify at least two e-Commerce systems that provide XML data integration. For each system, describe how XML extensions could enable e-Commerce integration among system stakeholders such as vendors, resellers, suppliers, and customers.
.
Written cases shall have the following sections Title, Introductio.docx
Written cases shall have the following sections: Title, Introduction: Issue and Cause Summarized, Analysis Decision Criteria, Alternatives,
Solution
, Justification for Choice of
.
www.amankas.comDistribution strategyDiscuss the company activi.docx
www.amankas.com
Distribution strategy
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Written AssignmentYou may choose one of these essay topics to writ.docx
Written Assignment
You may choose one of these essay topics to write an essay of 1500 words. It must include reference to at least 6 sources which you have found yourself. You must include a copy of your essay plan. You will also need to submit the piece to Turnitin. Please note that there are assessment criteria at the back of the Workbook.
ESSAY TOPICS
1. Why has it been claimed that students who use English as a second language are more likely to plagiarise?
2. What theories explain the difficulties international students face when they attempt to form intercultural friendships? What factors would enable both local and international students to form better intercultural friendships?
3. As higher education has expanded globally, there has been the potential to enhance intercultural communication on campus. Yet, is this truly internationalisation, or is it the increasing dominance of Western educational approaches?
4. Although for many the internationalisation of education has meant better employment opportunities and intercultural experiences, it has been suggested that universities are now commercial enterprises whose activities pose a threat to core university values. Discuss.
1500 words.
Need by 17/09 4:00pm AUSTRALIAN TIME(melbourne)
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1.4 modern child centered education - mahatma gandhi-2.pptx
1.4 modern child centered education - mahatma gandhi-2.pptx
2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...
Francesca Gottschalk - How can education support child empowerment.pptx
Francesca Gottschalk - How can education support child empowerment.pptx
You are a corporate compliance officer for a hospital. You are al.docx
- 1. You are a corporate compliance officer for a hospital. You are also a feature writer for The Medical Reporter , an online health magazine. The editor asks you to write an 8- 10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects: How to conduct an investigation. It should include the following elements: Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity? Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved? Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation? Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview. Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
- 2. How to develop a correction action plan. The plan may suggest: A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary. A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action. Assignment 1 Grading Criteria Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity. Explained the steps to take to determine who is involved in the complaint. Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation. Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview. Identified the criteria to determine if the allegations are substantiated or unsubstantiated. Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary.
- 3. Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted. Written Components: Style: Tone, audience, and word choice Organization: Introduction, transitions, and conclusion Usage and Mechanics: Grammar, spelling, and sentence structure APA Elements: In text citations and references, paraphrasing, and appropriate use of quotations and other elements of style