Arizona Med Lien Case Study

The staff should be very familiar with payment/collecting policy because you do not want everyone to tell the patients different things. The policy should be posted in the reception

HIM Personnel play an important role in the Medicare system. Medicare has transitioned from “fee for service” to providing incentive payments for providers that issue high quality care at affordable prices. In order to achieve the “pay-for-quality” incentives hospitals and health care officials must improve their documentation processes. “If it isn’t documented, it wasn’t done” is more important than ever. It is the responsibility of the HIM professional to ensure the integrity of the patient chart. HIM professionals monitor the quality of documentation and ensure all clinical documentation is complete and accurate. HIM professionals are the key to identifying process problems while keeping in mind patient safety, quality of care, and revenue integrity. Medicare requires that hospitals report quality improvement measures in order to receive payments; HIM professionals can directly impact Medicare incentive payments. HIM professionals are directly involved with the Medicare Audit Improvement Act. The HIM professional collects health data that is subject to the audits; HIM professionals are the point of contact for responding to Medicare audit requests.

You must be able to understand what the person requires, act on it from the initial information until the matter is concluded, pass on the information to the relevant person/s to ensure the patient’s needs are met, this process takes time to have faith in your colleagues, to challenge them if you feel the right

And at the center of the care. Medication that has been given to the individual has to also be reviews as it may have reached its time limit this means that they might become immune to it like some antibiotics people can become immune to so that this drug will not be affective. Checks have to be done to make sure that the medication is still effective and is working correctly and the patient isn’t suffering any side effects. If there are side effects occurring or the individual has become immune to their medication there will be investigations in to which alternative medication can be given to them that won’t react the same. Scans and x-rays may need to be repeated by the people that have put together the care strategy this is done so that if anything has changed that the individual Is getting care for or physic then this can be assessed again if they need this level of care and it can be changed, or on the other hand if the case has gotten worse and they symptoms are worsening then this also can be looked at and things can be done so that the individual is receiving the right care.

They say they will help with hospital bills and insurance claims and teach their patients and families how to ensure proper care of the patient after hospitalization” (AHA 2). The AHA defines patient’s rights as:

Translate health information correctly to insure the patient is receiving the correct type of care.

You are letting the provider know what the patient chief complaint or reasoning is to be seen at the office that day. All information the patient has prior will be beneficial for the process of the claim.

Monitoring everything, payroll, billing, human resource, scheduling, follow-up with nurses and employees, doctor requests, communicate with the doctor about patients and pre-authorization documents needed for the plan of care, HMO, training, physical therapy for patients.

It is important that the patient is aware not only of their rights, but of their individual responsibilities.

Use at least two patient identifiers when providing care. Double checking of ID bands and ID/Driver’s license of patient if possible. Using labels to mark all materials /items needed for the procedures. A two person check off procedure must be implemented. Items requiring labeling include: patient records, signed consents, and all assessments, diagnostic tests and x-rays. Also included should be any item that is needed for the procedure (blood products, devices, and equipment). Using a matching system, so that all items in the procedure area are matched to the patient. The matching system must be completed by a minimum of two staff members. These staff members should include a qualified staff member, nursing staff involved in the procedure, recovery room staff, and discharge staff.

2. Prior to the appointments scheduled, the administrative assistant need to contact the insurance companies of each patient that will be seen. They need to gather their EOB so they know the amount covered by them for the service/procedure as well as the amount that will be patient's

Spearheading from the last question, the regulatory categories pertain to this as well. The provider is responsible for putting the patient’s welfare above anything else, and system-wide rules should

sure my patients are taken care of and that the doctors are being informed of any changes with

-checking the eligibility of every patients insurance prior to each visit so they can find out

The law firm obtains the medical records from each medical provider in order to fully understand the extent of the person’s injuries, any pre-existing conditions that could have been complicated by the injury, and the medical treatment