...Professional Billing and Coding Careers MULTIPLE CHOICE 1. The percentage of all healthcare providers who are physicians and nurses is: a. 25%. b. 40%. c. 50%. d. 60%. Answer: b EMPLOYMENT DEMAND 2. The percentage of all healthcare providers who are allied health professionals is: a. 25%. b. 40%. c. 50%. d. 60%. Answer: d EMPLOYMENT DEMAND 3. The increased demand for medical billers, medical office assistants, and medical coders can be attributed to: a. the growth of managed care. b. physician practices having more responsibility for filing claims. c. the need for additional staff to file claims and work to obtain timely payment. d. all of the above. Answer: d EMPLOYMENT DEMAND 4. All of the following changes were a result of managed care EXCEPT: a. physicians having to wait 30 days or longer for payment. b. physicians having more responsibility for filing claims. c. patients having to pay for services when rendered. d. physicians having to add to their staff. Answer: c EMPLOYMENT DEMAND 5. Before the 1970s, a physician’s practice would grow based on: a. advertising and referrals. b. managed care contracts. c. consultations. d. hospital affiliations. Answer: a EMPLOYMENT DEMAND 6. Before the 1970s, a solo practice included all of the following staff members EXCEPT: a. physician. b. nurse. c. certified medical biller. d. receptionist. Answer: c EMPLOYMENT DEMAND 7. Managed care is a system in which physicians contract...
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...Doctor Shortage Impacts Rural Areas Jean Larsen Senior Project Kristi Hund March 1, 2011 Abstract The United States is experiencing a substantial shortage of physicians, which is creating a severe supply and demand problem in America. Citizens living in rural areas should receive the same quality of care as those living in urban settings. Substantial differences exist in quality and access to health care for persons living in rural America. The shortage of physicians in rural America calls for immediate attention and change, as the inadequate supply of physicians is affecting the quality of patient care. The life expectancy of persons living in rural America is actually declining due to treatable conditions such as diabetes, cancer, heart disease and chronic obstructive pulmonary disease. These illnesses could be managed with proper medical treatment. This paper addresses these issues and recommends two solutions. Healthcare is in crisis in many countries, not least of which is the United States. We hear on the news how health care providers are unable to provide medical care to an increasing number of chronically ill and the aging population. There are a number of systemic failures, none is more difficult to correct than the basic lack of human resources. There are simply not enough physicians to service the needs of the population. The problem is intensified in rural areas, where specialized physicians may not be found within several hundred miles. The healthcare...
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...ram4577X_ch03.qxd 4/16/04 11:50 Page 37 Legal and Ethical Issues in Medical Practice, Including HIPAA AREAS OF COMPETENCE 2003 Role Delineation Study CLINICAL Fundamental Principles ɀ Apply principles of aseptic technique and infection control ɀ Comply with quality assurance practices Patient Care ɀ Coordinate patient care information with other health-care providers GENERAL Legal Concepts ɀ Perform within legal and ethical boundaries ɀ Prepare and maintain medical records ɀ Document accurately ɀ Follow employer’s established policies dealing with the health-care contract ɀ Implement and maintain federal and state health-care legislation and regulations ɀ Comply with established risk management and safety procedures ɀ Recognize professional credentialing criteria CHAPTER OUTLINE ɀ ɀ ɀ ɀ Medical Law and Ethics OSHA Regulations Quality Control and Assurance Code of Ethics ɀ HIPAA ɀ Confidentiality Issues and Mandatory Disclosure OBJECTIVES After completing Chapter 3, you will be able to: 3.1 Define ethics, bioethics, and law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Describe OSHA requirements for a medical office. KEY TERMS abandonment agent arbitration assault authorization battery bioethics breach of contract civil law contract crime criminal law defamation disclosure durable power of attorney electronic transaction record ethics expressed contract felony fraud ...
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...benefits. 1.3 Identify the key steps in the medical billing cycle. 1.4 Discuss the impact of electronic health records on clinical and billing workflow. 1.5 Evaluate the importance of professional certification and of medical liability insurance for career advancement. S te p4 Medical Billing Cycle Prepare and transmit claims 1 accounts payable (AP) accounts receivable (AR) benefits cash flow certification coding coinsurance copayment covered services deductible diagnosis documentation electronic claim (e-claim) electronic health record (EHR) fee-for-service health care claim health information technology (HIT) health plan indemnity plan managed care managed care organization (MCO) medical assistant medical billing cycle medical documentation and billing cycle medical insurance medically necessary noncovered (excluded) services out-of-pocket PM/EHR policyholder practice management program (PMP) preauthorization...
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...Pygmalion in Management* In George Bernard Shaw's Pygmalion, Eliza Doolittle explains: "You see, really and truly, apart from the things anyone can pick up (the dressing and the proper way of speaking and so on), the difference between a lady and a flower girl is not how she behaves, but how she's treated. I shall always be a flower girl to Professor Higgins, because he always treats me as a flower girl, and always will; but I know I can be a lady to you, because you always treat me as a lady, and always will." Some managers always treat their subordinates in a way that leads to superior performance. But most managers, like professor Higgins, unintentionally treat their subordinates in a way that leads to lower performance than they are capable of achieving. The way managers treat their subordinates is subtly influenced by what they expect of them. If a manager's expectations are high, productivity is likely to be excellent. If his expectations are low, productivity is likely to be poor. It is as though there were a law that caused a subordinate's performance to rise or fall to meet his manager's expectations. The powerful influence of one person's expectations on another's behaviour has long been recognised by physicians and behavioural scientists and, more recently, by teachers. But heretofore the importance of managerial expectations for individual and group performance has not been widely understood. I have documented this phenomenon in a number of...
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...rising cost of Healthcare can be attributed to the over use of emergency departments (EDs) for non-emergency needs. In the greater Capitol/First/Beacon Hill area there are three major hospitals (Virginia Mason, Harborview, and Swedish) with emergency rooms and no urgent care centers with the exception of Group Health which is restricted to Group Health insurance members. The question I asked myself is, “Why does Group Health have urgent care for their insurance plan members and the major hospitals in Seattle do not.” Urgent vs. Emergency Care A study by the CDC showed that approximately 70 % of emergency department visits can be treated in a typical primary care or urgent care setting and another study by National Center for Policy Analysis demonstrated that only 13% of patients that sought treatment in the emergency department were clinically appropriate. Reasons for non-emergency visits to the ED range from access issues to primary care providers (wait times, no primary care provider assigned, or no insurance) to a lack of knowledge that they could have been treated at an urgent care or primary care setting. There are good reasons to visit the emergency department: * Trauma due to an accident or assault | * A wound that will not stop bleeding | * Shortness of breath | * Vomiting blood | * Chest pain | * Sudden loss of consciousness | For true emergencies the market is very inelastic, patients will spend whatever it takes to receive treatment...
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...Health Services Finance Recruiting and Retaining Nurses Health Services Finance HS543ON June 16, 2011 ISSUE/BACKGROUND With quickly changing demographics, new technologies, limits on resources and public expectations the health care arena is constantly changing at a quick pace (Nowicki, p. 338). The Bureau of Labor statistics reported in April 2011 that despite the recent economic downturn and high unemployment health care is continuing to grow. It was estimated that approximately thirty seven thousand jobs were added in March 2011 alone (AACN). The staffing of registered nurses has been a long time concern due to the fact the shortage greatly affects patient safety as well as quality of care (nysna.org). Studies have shown that adverse patient outcomes have been related to the ineffective nurse staffing as patients have had longer hospital stays, increased infections, and higher mortality rates (Needleman, et al, 2002). To relieve the pressures put on an organization with the shortage many have begun to substitute people who are not as prepared to care for patients. This has been done by hiring temporary nursing services or recruiting foreign nurses who are not familiar with the facility, policies and procedures or the patients ( nysna.org). The ineffective nurse staffing also leads to retaining issues as nurses experience decreased morale, increased stress and anxiety, increased physical ailments, and burnout. DEFINE THE PROBLEM The problem...
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...Company Introduction: Assured & Associates offers a unique combination of premier home health care and community-based social services to the Atlanta, GA metro area. Market research indicates that there is a significant need for quality home health care and social services within this region and we believe that by employing competent and well-educated staff and providing them with organized and responsive management, we can become the home health care/social service agency of choice in Orlando, FL. Assured & Associates will be created as a Limited Liability Company based in Orange County. owned by its principal investors and principal operators. The initial office will be established in quality office space at 1800 Pembrook Drive in Orlando, FL which is the heart of Orlando. Pembrook Commons is located close to a hospital facility, which will serve as referral bases for our agency. Consumers of our services will be those individuals and families in need of home health care and/or social services. These patients are usually referred by other health care professionals such as physicians, attorneys, insurance companies and health care facilities. Our agency has already developed an excellent reputation with many of these professionals, through the work of our Registered Nurse, who has been providing home health care services for the past twenty years. Our agency must be licensed by the State of Florida and our services reimbursed by Medicare, Medicaid and other private...
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...Katherine Bailey CET 3010 Course Project Professor Yousef By Katherine Bailey CET 3010 Course Project Professor Yousef By Better Your Small Business Today Better Your Small Business Today Contents Introduction: 1 Current Business Process: 1 Patient Arrival 1 Check in Process: 1 Wait in waiting room 2 Urine Sample 2 Wait in waiting room for nurse 2 Nurse takes/records vitals on paper 2 Wait to see Doctor 2 See Doctor 2 Check Out: 2 Data Collection and Analysis: 3 Type of data collected: 3 Recommendation for collecting proper data using information technology: 3 Recommendation: 3 Digitized Form 4 Data and System Security 4 Ethical Issues: 5 Guidelines: 5 System Requirement’s: 6 System: 6 Other Requirments: 6 Conversion 7 Direct Data Entry 7 Idea: 7 References 8 introduction: I have been called to one of the Atlantic Urological Associates offices to provide recommendations for an efficient information system that will help with the following: * Minimize patient waiting time * Decrease paper work between the office and other healthcare entities * Increase quality of patient care * Optimize the billing and coding process Upon arriving at the doctor’s office I notice the waiting room is full and there is a line of people waiting to check in. Behind the desk is an overstressed receptionist who is trying to manage checking everyone in, answering the phones, and filing/completing paper work. When...
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...Southwestern Assemblies of God University School of Distance Education Methadone Treatment Programs are Effective in Stopping Heroin Use A Paper Presented to Professor Loyd Uglow, Ph.D In Partial Fulfillment of The Requirements for the Course THE 5113 Research Literature and Technology Sharon Pete November 28, 2012 THESIS STATEMENT: To investigate Methadone maintenance is found to be more effective in treating heroin addiction than 180 day detoxification. The objective is how methadone maintenance, a widely used but controversial method of weaning heroin addicts off the drug—with counseling has psychosocially enriched 180 day methadone assisted detoxification. OUTLINE I. INTRODUCTION A. History of Heroin B. History of withdrawals II. How Methadone is used to treat Heroin? III. Research Findings IV. CONCLUSION V. Work Cited Methadone Treatment Programs are Effective in Stopping Heroin Use Substitution treatment or maintenance pharmacotherapy programs using methadone are today the most sought after and effective form of treatment for opiate addiction and dependence. Because methadone is a long-acting opiate whose dosage can be stabilized, it is well suited for daily administration and has proven effective in the elimination of narcotic craving, a driving force behind continued heroin use. And, because it can be administered orally, methadone dramatically reduces heroin injecting frequency...
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...Milkovich−Newman: Compensation, Eighth Edition I. Internal Alignment: Determining the Structure 4. Job Analysis © The McGraw−Hill Companies, 2004 Chapter Four Job Analysis Chapter Outline Structures Based on Jobs, People, or Both Job-Based Approach: Most Common Why Perform Job Analysis? Job Analysis Procedures What Information Should Be Collected? Job Data: Identification Job Data: Content Employee Data “Essential Elements” and the Americans with Disabilities Act Level of Analysis How Can the Information Be Collected? Conventional Methods Quantitative Methods Who Collects the Information? Who Provides the Information? What about Discrepancies? Job Descriptions Summarize the Data Describing Managerial/Professional Jobs Verify the Description Job Analysis: Bedrock or Bureaucracy? Judging Job Analysis Reliability Validity Acceptability Usefulness A Judgment Call Your Turn: The Customer-Service Agent Three people sit in front of their keyboards scanning their monitors. One is a sales representative in Ohio, checking the progress of an order for four dozen picture cell phones from a retailer in Texas, who just placed the four dozen into his shopping cart on the company’s website. A second is an engineer logging in to the project design software for the next generation of these picture cell phones. Colleagues in China working on the same project last night (day in China) sent some suggestions for changes in the new design; the...
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...Introduction This report is analysis of the Health and Rehabilitation center Envoy of Pikesville. Althea Layne director of nursing (my mother) has been at her management position for over 8 years. Envoy of Pikesville, located in Pikesville, Maryland was acquired in 2009. Envoy of Pikesville has been providing services to the geriatric population for over 35 years. Our two-story building has a large, state-of-the-art rehabilitation gym, a welcoming dining experience, and a serene inner courtyard. We feature an outstanding rehabilitation team that includes speech, physical and occupational therapy with 85% of our residents returning home. Their skilled nursing service’s resident-focused approach provides those who have suffered from a prolonged acute or chronic illness or have recently been injured or undergone surgery with the best care possible. In these cases, residents' conditions are often stable, but they continue to require assessment and treatment. And whether it’s nutritional support or assistance with self-care and the activities of daily living, our team is committed to meeting the needs of each resident at every stage of recovery. Their full range of rehabilitative services assists residents with physical, cognitive, psychosocial, and/or communication impairments. Respiratory, physical, occupational, and speech therapy programs use the coordinated efforts of an interdisciplinary team to contribute to each resident's rehabilitation – helping to ensure a successful...
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...government entities and the public about the history, role, educational preparation, laws governing practice, standards of practice, evidence base of the profession, payment for physical therapy services, and workforce issues unique to the physical therapy profession. As government, private health care entities, and provider groups pursue solutions to the considerable health care provision challenges the United States faces, it is imperative that accurate information about the qualifications and roles of specific providers, in this case physical therapists, be available to inform all entities as they engage in these discussions. APTA is the national professional association representing more than 77,000 physical therapists, physical therapist assistants, and students nationwide. The association acknowledges and thanks the Federation of State Boards of Physical Therapy, the national organization representing 51 boards of physical therapy licensure, for input and assistance with this document. © 2011 American Physical Therapy Association. All rights reserved. i | American Physical Therapy Association Table of Contents Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Executive Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Chapter 1: History of the Profession of Physical Therapy...
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...Improving Medical Information Security A Term Paper IS 535 - Managerial Application of Information Technology Keller Graduate School of Management Table of Contents Introduction/Definition Company Background Current Business Issues Proposed Solutions Recommendations Introduction The security of patient data has been, and continues to be, a major problem for the US in achieving its goals for an interoperable healthcare system. In the same way, information communication technologies will increasingly make security in organizations more complex. It is particularly evident in sectors that already lack adequate security regimes. One such sector is healthcare, where information security is not their core business and the understanding of its importance is often underestimated. Poor implementation of medical information security is affected by more than the acceptance of technology; it is closely linked to human factors, culture and communities of practice, all under pinned by trust. It also poses a problem because within the healthcare arena the entire nation is trying to standardize and move into Electronic Health Records (EHR), which is simply a shift from the original paper format of a patient’s medical history and record to a computerized, electronic standpoint. This situation necessitates research into how to contextualize implementation of information security...
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...Date: October 21, 2012 Table of Contents Introduction 2 Background 2 Define the problem 3 Literature Review 4 Problem Analysis 6 Possible Solutions 10 Solutions and Implementations 12 Justification 13 References 14 Introduction Attention to medical errors escalated over five years ago with the release of a study from the Institute of Medicine (IOM), To Err is Human, which found that between 44,000 and 98,000 Americans die each year in U.S. hospitals due to preventable medical errors. Hospital errors rank between the fifth and eighth leading cause of death, killing more Americans than breast cancer, traffic accidents or AIDS. Serious medication errors occur in the cases of five to 10 percent of patients admitted to hospitals. These numbers may understate the problem because they do not include preventable deaths due to medical treatments outside of hospitals (Vantage Professional Education, 2009). Background Medical malpractice is professional negligence that can cause injury which may result in death, substantial economic damages to the patient. Most cases of medical malpractice involve inaccurate diagnosis or misdiagnosis. There has been various and unfolding problems occurring in the United States domestic healthcare for many years. The most grave problem experienced in the healthcare industry is the suborn increase of medical...
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