My Doctor 's Office For Physical Therapy

Husband and wife, Gary and Renna Pehle were infected with HIV at the time they applied for life insurance with Farm Bureau Life Insurance Company. The couple did not know they were infected with HIV at the time. The insurance company ran blood tests from the Pehles. The Pehles then signed a contract form which was given to them by a Farm Bureau agent. A nurse from Farm Bureau watched as the Pehles signed the contract. Blood samples were sent to a third-party laboratory called LabOne. Farm Bureau then sent a notice to the Pehles rejecting them from their life insurance policy, which advised the couple that if they wished to have their application reviewed to contact their physician. The Pehles did not take any action in doing so. Two years past and Renna Pehle is confirmed to have AIDS. The Pehles then sues Farm Bureau, LabOne, and LabOne’s medical director Dr. J. Alexander Lowden for negligence, for failing to tell them they were HIV-positive.

This is a report of an Interview with Karen Gordon-Sosby, associate director at Texas State Student Health Center. Karen is a highly motivated professional, an experienced healthcare administrator and appears to possess inherent management and leadership skills that are quite significant and noteworthy. Her expertise in performing the indispensable task in managing and analyzing financial records, brings a unique blend of health administration and public health prowess to the healthcare industry.

1. During the interview, the interviewer (Dr. Noonan) was able to control the session even when the client was challenging her. Dr. Noonan continued to repeat the question "How can I help you?" when the client avoided answering Dr. Noonan about why she was seeking services from her. The interviewer also maintained patient confidentiality when the client mentioned a previous coworker that had also seen Dr. Noonan. Dr. Noonan did not give any information to the client about this previous patient and she did not give any indication that she had been this coworker's doctor in the first place.

“The Health Insurance Portability and Accountability Act (HIPAA) of 1996 made it illegal to gain access to personal medical information for any reasons other than health care delivery, operations, and reimbursements” (Shi &ump; Singh, 2008, p. 166). “HIPAA legislation mandated strict controls on the transfer of personally identifiable health data between two entities, provisions for disclosure of protected information, and criminal penalties for violation” (Clayton 2001). “HIPAA also has privacy requirements that govern disclosure of patient protected health information (PHI) placed in the medical record by physicians, nurses, and other health care providers” (Buck, 2011). Always remember conversations about a patient’s health care or

Everyone knows there is no dearth of academic material to cover during medical school, so learning the basic business and administrative skills surrounding medical care is often sacrificed, and like all Medical Practitioners, our focus is always on the patients. Similarly, pharmaceutical companies often approach us with new treatment options that require a complex cost-benefit analysis, and insurance companies have a complex frustrating mechanism that must be followed to be reimbursed for services

The healthcare system in America started as a predominantly volunteer system where patients were required to pay little to nothing for treatment. Since it began, the healthcare industry has seen tremendous changes that have transformed it into a business entity which has operations like financial management, strategic planning and functional specialties to keep the industry viable. The industry is one of the largest in the country employing 15 million people with a projected increase of jobs with 3 million jobs annually. As the healthcare industry continues growing, services and personnel are changing, and various dynamics are coming into play to accommodate changes (Smith, Saunders, Stuckhardt, & McGinnis, 2013).

Amy holds a bachelors degree in accounting and has worked in the medical billing field for over twenty-five (25) years. Her exhaustive knowledge of reimbursement coupled with her attention to detail has been essential in servicing new and existing clients. Her leadership and knowledge, has in every aspect of the revenue cycle

The U.S. Healthcare delivery system has been impacted with increasing administrative costs and a recent survey by Casalino revealed that physicians are spending about three hours each week working on the health plans they support. The time is being consumed on many administrative tasks that include confirming that the medication being prescribed is covered, checking if specialist is in the plan’s preferred network, and managing the preauthorization of medical forms for specific care.

North Central Ohio Rehabilitation Center initially was an addition for the JDC next door. However, the State of Ohio started the RECLAIM act as a response to juvenile court and Department of Youth correctional overcrowding (Ohio Department of Youth Services). RECLAIM stands for reasonable and equitable community and local alternatives to the incarceration of minors. This act was implemented in January of 1995 and there are currently only 12 community facilities in the state of Ohio. NCORC opened its door as a community facility because of this act in 1996 (Wrentmore, 2015). Initially, NCORC housed boys and girls in the facility. However, later on it was decided boys would be much easier to house. The mission statement at NCORC is to make a positive and instrumental difference in the lives of youth by providing rehabilitative treatment to meet their individual and collective needs to become productive law abiding citizens (North Central Rehabilation Center). It has not changed at all it the last five years. The facility very much follows this statement even when the boys are less than willing to try and make positive changes.

Aetna’s customized iTriage app helps employers make better health care decisions based on appropriateness and affordability of care. Aetna launched this customizable app to allow customization of information for consumers based on their specific health benefits plan. It helps employers to understand how using an in-network health care provider can be more affordable, which can also be used to create cost savings for employers and reduce administrative work for health care providers, who will benefit from informed patients, who have selected the right physician, facility and level of care based on their individual needs. The iTriage app is Aetna’s vision of creating a better healthcare experience for their customers and their employers (Aetna,

A hospital employee violated several policies mandated in the Health Insurance Portability and Accountability Act. She failed to observe the minimum necessary requirement, did not follow the confidential communications requirements, and disclosed the patient’s treatment plan and medical condition. It also appeared that the hospital’s standard staff training procedures was not sufficiently evaluated.

I think the insurance billing specialist violated HIPAA standards, because before any info can be given out a consent form has to be read and signed by Barbara Smith. Giving who it may concern the right to disclose past treatments or illnesses. In an article written by Robert C. Kellner, he states that “if your employer asks your health care provider directly for information about you, your provider cannot give your employer the information without your authorization unless other laws require them to do so”. (Kellner, 2002) Kellner also stated that “Subsection (d) limits the medical inquiries which employers may make of applicants and employees, obligates employers to use separate forms to collect any information regarding the medical condition

The Marylhurst Healthcare MBA program and 26 years of work experience in the healthcare industry will enable me to help others find and receive affordable quality healthcare. Even though, we have Obama Care people are complaining that they cannot receive quality medical care at affordable prices. In some cases, they are going without medical treatment because they cannot afford the co-pays. In addition, some people want to obtain natural healthcare and most insurance companies will not cover important naturopathy testing. It is this that has inspired me to learning the business aspect of running a hospital and using this knowledge to become a healthcare advocate.

The document will explain how unethical and disturbing her behavior was by falsifying a patient information and the document should further highlight additional corrective actions that may be taken if she were to repeat this act. In addition, she should receive additional training in the policies and requirements for providing accurate medical data, the legal perspectives of employee responsibilities, and consequences for employee misconduct. Plus, an investigation should be opened up in the matter to evaluate Ms. Smith entire performance for that day and whether she might have falsified patient data previously in other situations. This procedure may unravel potential issues that can pose harm for the organization in the

The outlook and future for billing and coding professionals seems to look brighter as information technology continues to advance in healthcare in a positive way. Employment opportunities are expected to grow at a much faster rate than other average occupations. With the transition from ICD-9 codes to the new ICD-10 system, the demand for skilled medical billers and coders is particularly high right now which translates to more jobs with higher salaries. There are a few factors that continue to contribute to the demand for medical billing and coding professionals one being that more Americans are insured and the average population age is increasing as baby boomers approach retirement and the increased demand for healthcare services. The importance