Hsa 546 Week 4

Willow Bend Hospital’s compliance does indeed have multiple deficiencies and is in need of review as many were updated in 2009 and 2010. All information on deficiencies would be found on the latest updated version of the Joint Commission Information Standards. This should be located within the Corporate Compliance/Risk Manager’s office. As this information is not currently available to this writer without a subscription and fee, I must use the information available to me. So expansion and explanation of policy details are limited.

The OIG working through the DHHS attempts to guarantee that secured elements act inside the bounds of protection and security laws set up in HIPAA and related federal healthcare legislation. One of the OIG’s principle obligations is respect to the medical billing and coding industry is the avoidance of deceitful movement among secured elements. As a restorative charging and coding authority you should be cautious about potential action that might be fraudulent by the OIG.

In the case of study “Missed Opportunity” there is a character by the name of Susan Daniels. Ms. Davis is the top marketing officer of Briarwood Medical Center, there she is trying to secure to billboards located on the premises. This is a prize location because the billboards panels are located on the main traffic strip. The panels will provide countless opportunities to market the medical center and an excellent investment. Briarwood Medical Center was entangled in a endless battle for the market share against a skilled competitor Crestview Hospital, thus making every opportunity to win patients crucial. This is an opportunity

The benefits and drawbacks of having state health programs verses one that is uniform across the country can vary on a broad basis. Medicare and Medicaid are state and federally funded health programs; programs that must be fair and allow access to everyone across the country that are enrolled and eligible to receive such benefits. In addition, these programs have unlimited caps so that there is flexibility to continue financing care without delay. The Medicare program was designed to provide access to health care for those who are not able to afford appropriate health care and meet the needs of vulnerable communities. If it were not for the assistance of the federal government in providing states the necessary funds to continue providing health

The federal government is involved in all parts of health care at the national, state, and local levels. They have public

Patients, as consumers have a say on the decisions a healthcare facility makes regarding integrating CAM practitioners in their clinical practices. As such, a specialty clinic’s Chief Medical Officer should pay attention to the consumer suggestions. The patient should know that they will be granted the right to make health care decisions that resonate with their preferences, wishes, and values. Additionally, a patient would want to know whether the practitioners would respect their autonomy, regarding treatment decisions and health care goals, and act in patients’ best interests, according to fiduciary duties.

Provide advice and recommendations to minimize risk and enhance Piedmont Healthcare compliance with required laws and regulations.

To assist in the prevention of errors, abuse and fraud in healthcare, the Federal OIG (the Office of Inspector General) and Medicare respectively publish the Compliance Program Guidance for Individual and Small Group Physician Practices and the Medicare Carrier’s Manual. In order to stay in federal compliance and prevent errors or worse, is it beneficial to be familiar with these documents. In a large company, while the Medical Office Specialist is the person that must be familiar to with the Medicare website this person is also the designated Compliance Officer and is responsible for providing the information on rules and guidance to the coders. To contact your medical office specialist, please refer to the company website or phone directory for your division. Remember, the federal government is not forgiving on errors when your response is ‘I don’t know’.

According to the textbook, “The operational implications of implementing a compliance plan in any size practice actually extend beyond the basic compliance elements. In fact, many of the elements, as implemented, may represent features and functions that have never existed in physician practices or do exist, but in basic forms.” (Wolper,

Will the compliance officer be responsible for employee or medical staff sanctions screening, or for other services such as physician

"To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value” (Jointcommission.org, 2015). These requirements are regimented in the National Patient Safety Goals and are enforced via surveys and internal inspections to ensure that healthcare institutions abide by the safety mechanisms put in place to facilitate the optimal patient outcomes and environments.

guidelines stated that registrants should practice safely and efficiently within their scope of practice, practice within the legal and ethical boundaries and understand all requirements set out by the HCPC. ODPs must maintain a good and safe practice environment with the understanding of the impact of human factors during peri-operative setting (HCPC, 2014)

Practice: review, plan and monitor, eg respect for the value base of care, professional interactions with

The WHO definition of compliance is “the extent to which the patient follows medical instructions” . However, the term “medical” is felt to be insufficient in describing the range of

The Federal Employee Health benefit program is the largest employer health insurance program in the United States, insuring about 3 percent of all Americans. There are 133 plans, offering 188 coverage options that are participating in the FEHBP as of 2003. Preferred provider organization (PPO), fee-for-service plans, and Health Maintenance Organization (HMO) all offer options. The government’s contribution toward the cost of the beneficiary’s premium is “lesser of 72 percent of the average FEHBP plan premium, weighted by enrollment, or 75 percent of the premium for the plan chosen” (Karen Davis) .