Departmental Impact on Reimbursement Instructions

Understanding the Impact of Departments on Reimbursement

Task:

Draft of Departmental Impact on Reimbursement Instructions Submit a draft of Section II of the final project (Departmental Impact on Reimbursement). For additional details, please refer to the Milestone Two Guidelines and Rubric document. rview: 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. Milestone Two provides you an opportunity to engage with real-world data that you would encounter in an actual professional environment.

Specifically, you will take a closer look at how reimbursement impacts other healthcare departments, and you will dive deep into utilizing data, tracking records, and ensuring compliance within individual departments. Prompt: Submit a draft of Section II of the final project. Specifically, the following critical elements must be addressed: II. Departmental Impact on Reimbursement

A. Describe the impact of the departments at this healthcare organization that utilize reimbursement data. What type of audit would be necessary to determine whether the reimbursement impact is reached fully by these departments? How could the impact of these departments on pay-forperformance incentives be measured?

B. Assess the activities within each department at this healthcare organization for how they may impact reimbursement.

C. Identify the responsible department for ensuring compliance with billing and coding policies. How does this affect the department’s impact on reimbursement at this healthcare organization? Guidelines for Submission: Your paper must be submitted as a two- to three-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and at least three sources, which should be cited in APA format. Rubric Critical Elements Proficient (100%) Needs Improvement Needs Improvement (75%) Not Evident (0%) Value Departmental Impact on Reimbursement: Departments Comprehensively describes the impact of the departments that utilize reimbursement data at this healthcare organization that also influence reimbursement Describes the impact of the departments that influence reimbursement, but description is not comprehensive or is not specific to this healthcare organization or to departments that utilize reimbursement data Does not describe the impact of the departments at a healthcare organization that influence reimbursement 30 Departmental Impact on Reimbursement: Activities Assesses the activities within each department at this healthcare organization for how they may impact reimbursement Assesses the activities within each department at this healthcare organization but does not explicitly link these activities to reimbursement, or assessment is not specific Does not assess the activities within each department at a healthcare organization for how they may impact reimbursement 30 Departmental Impact on Reimbursement: Responsible Department Correctly identifies the department responsible for ensuring compliance of billing and coding policies and its impact on reimbursement at this healthcare organization Identifies the department responsible for ensuring compliance of billing and coding policies and its impact on reimbursement at this healthcare organization, but identification is incorrect Does not identify the department responsible for ensuring compliance of billing and coding policies 30 Articulation of Response Submission has no major errors related to citations, grammar, spelling, syntax, or organization Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas 10 Earned Total 100%