Quality Improvement consists of systematic and continuous actions that lead to measureable improvement in health care services and the health status of targeted patient groups. (hrsa.gov) Improving customer satisfaction can be an overwhelming task. Unfortunately most health care offices (especially specialists) are packed with impatient patients. Even with the implementation of quality initiatives there could still be some challenges. There may be some unforeseen emergencies, among other problems that will arise. The goal is to implement practices that ensure the best patient experience possible. One quality initiative could be giving out surveys to patients after their visit. They would be designed to address any concerns or problems the …show more content…
Coordination of patient care is another measure for quality of service. Hospitals can make available health plan models of care. The responses will be available to the community to measure how the hospital will improve its services and care to the community. The third area is clinical documentation improvement (CDI). There is increased governmental oversight with programs such as Medicare, Medicaid, and ACA (Affordable Care Act) that monitor care and codes for billing.(Pink, 2009) When documentation is clear across all departments, patients have fewer questions. Physicians, have fewer disruptions and can focus on medical care. Streamlining the time between approval, billing, and reimbursement to the hospital is a cost saving measure. Separate coding departments cause delays and cost money; bringing together billing and coding have shown to save time and money. One hospital, checks records daily for completeness. When organizations promptly address omissions in record keeping, actual clinical documentation provides an objective analysis of service to the …show more content…
The provider has to learn reimbursement policies, determine how quickly the practices gets paid, how simple or difficult it is to file a claim. Also take into consideration how much they reject or accept claims. What is the process of getting reimbursed if the claim is denied? Medicare and Medicaid are two very different insurances which cover different things. They each have their own benefits and negative attributes. It is a well-known fact that Medicare only covers 80% of medical necessities. The other 20% would come from another private health care insurance or the patient. Prior to accepting or rejecting Medicare as an insurance you want to put some rules into place. 1) Have the patient put a deposit towards the 20% that is not covered. (If they do not have a supplemental insurance). 2) Have a form of payment to cover any costs that are not covered under the Medicare plan.
Medicaid "is a program that was instituted in the year 1965. It was enacted to give health insurance to low income families and people with specific disabilities. Each state has its own administration, however the money comes from the federal government." (Teitelbaum, Wilensky, 2017, Page