To process claims accurately and effectively, billing professionals must understand how a clean claim is prepared and what issues can contribute to a dirty claim. When managing a team of billing professionals, it is important to understand how internal and external factors contribute to a smooth process vs. a rejection or denial. Summarize internal factors (within your organization/facility) that can positively or negatively influence the life cycle of a claim. Summarize external factors (outside of your organization/facility) that can positively or negatively influence the life cycle of a claim. From a leadership perspective, how can you ensure your team is effectively trained and confident in navigating internal and external challenges with claim processing?

Q: Describe the benefits and challenges of performing a comprehensive risk assessment for a healthcare…

A: In the healthcare industry, the medical professional performs a comprehensive observation for the…

Q: Think of a clinical setting with which you are familiar and envision how Al tools might be applied…

A: Artificial intelligence technology enables the human and computers to communicate it clearly and…

Q: a. Name and explain any four properties of health care services. b. What are the characteristics of…

A: (a) Quality health care can be determined in different methods but there is developing confession…

Q: Summarize the steps a claim must go through in order to be processed and payment received for…

A: A claim for health insurance is an application submitted by the policyholder to the health provider…

Q: Discuss the intetactive process helping client. Documentation and reporting. Purpose of client…

A: Regardless of the practice context or whether the documentation is paper-based or electronic, it is…

Q: Discuss Possible legal,ethical and disciplinary implications of false documentation

A: Documentation in the field of healthcare is either written or electronically generated data that…

Q: Long term care facilities require 4 areas of documentation, what are they?

A: Documentation is a process of recording the patient details. This includes medical diagnosis,…

Q: mmarise relevant ethical and legal issues that might arise in relation to advance care plan

A: Advance care planning is not about the care for old age population, but planning for health care…

Q: What is long term reimbursement in health care

A: The annual study to set Medi-Cal rates for a range of long-term care providers is conducted by the…

Q: Describe the roles of the nurse as defendant, factwitness, and expert witness.

A: In the healthcare system, there are several laws put forward to avoid malpractice. In nursing, this…

Q: Discuss the conundum of balancing a clients right to confidentiality and disclosure of concerns

A: Patient confidentiality is a phenomenon where a doctor cannot disclose or discuss the patient’s case…

Q: f federal workman compensation claim in nursing

A: Workplace injuries or trauma are mostly costly where an employee cannot work for some period of time…

Q: Describe the various sources of funding beyond third-party reimbursement from which the various…

A: The health facility is a location where healthcare is given. These range from small clinics and…

Q: process of submitting a claim

A: The health insurance contributor comes into an agreement with the health insurance organization to…

Q: A patient receives a $420 medical procedure and has a 70/30 coinsurance agreement and a $100…

A: According to the question, the insurer will reimburse 70 parts of the cost while the patient will…

Q: Describe three scenarios for the following types of disclosure: accidental, incidental, and…

A: Health information of the patient is official as well as personal data. But there are circumstances…

Q: discuss a minimum of two strategies a healthcare provider can adopt to minimize barriers and…

A: Studies suggest that many individuals find it difficult to understand the instruction given by their…

Q: Describe a situation where it would be useful for a nurse to create and print a report from a…

A: Database in healthcare is the record of patient information. It is updateable and accessible by the…

Q: What are the aspects of an administrative medical assistant’s behavior and attention to procedure…

A: We how that It is the responsibility of an administrative medical assistant to contribute…

Q: What are all the important aspects of a medical assistant's role in the insurance claim process?

A: One of the central operations of the medical office is the processing of insurance claims. A…

Q: Differentiate the administrative functions of long-term care practices from those of other…

A: The entire healthcare system is very complex and managing this entire system is not easy work. An…

Q: Explain how the many facets of culture affect a health care provider's ability to provide culturally…

A: A way of life of a group of people is known as a culture. It includes the:-The behaviours, -beliefs,…

Q: Do you think NANDA-I, NOC & NIC are applicable to Nursing Documentation (conventional written or…

A: Clear and point by point nursing documentation can depict the patient's status, advance within the…

Q: the significance of documentation in mortuary services of the hospital

A: The mortuary is an important aspect of any hospital since it is responsible for preserving the dead…

Q: Effective Counseling Techniques are skills which, when practiced effectively by a knowledgeable…

A: The emphasis on counseling to make the patient stress free is increasing. With the new definition of…

Q: Select the Health Insurance Portability and Accountability Act (HIPAA) requirements that specify how…

A: The Health Insurance Portability and Accountability Act (HIPPA) is a federal law that was…

Q: What is the difference of negligence to malpractice? Give me an example of malpractice and relate it…

A: Negligence is misconduct by a healthcare provider when they do not provide complete care to the…

Q: Describe the professional, disciplinary, and ethical considerations underpinning nursing practices.…

A: A solid foundation of rules is important to form the basic structure of the profession. Nurse not…

Q: What strategies can you use in initiating, negotiating and implementing strategies for addressing…

A: Client right is the legal assurance of the client to be treated as a person, able to decide to…

Q: Psychiatric disorders diagnosed most commonly by psychiatrists are recorded by using ___________,…

A: Psychiatric disorders associated with the conditions related to affect mood, behavior and thinking.…

Q: Discuss the local and system factors that might have impacted on quality and safety in healthcare.

A: Understanding the factors in shaping with the patient safety and quality of health care is very…

Q: Which of the following provides a comprehensive way to store and share a health record, both inside…

A: Health records are the documents related to patients illness and treatment which contain all the…

Q: Explain the role of an advocate in supporting individuals accessing services.

A: Advocates are the personals who works  hardly to support and meet the other personals to achieve…

Q: What are  two ways a healthcare provider could violate the HIPAA law, and what are alternative…

A: A healthcare provider is a person who works in the favour of the patient in order to provide care to…

Q: explain how nursing documentation helpsnurses and the whole health care facility in providing…

A: Documentation of the client's medical record is an important aspect of nursing care. The nursing…

Q: types of fraud that may have impact on a nurse's license

A: Types of fraud that may have impact on a nurse's license are  Upcoding. Allowing nurses and staff…

Q: Illustrate how the technology of electronic record has altered healthcare administration and patient…

A: The adoption of electronic health care records has provided a number of substantial benefits in the…

Q: plain thoroughly from a medical perspective. What is a chain of custody form??

A: Forensic science encompasses scientific knowledge from many scientific areas. The knowledge from…

Q: What is the difference between a wrongful life case and a wrongful birth case? How is the…

A: Here we have to describe about the difference between a wrongful life case and a wrongful birth case…

Q: Discuss the relationship between documentation and financial reimbursement for health care ?

A: The reimbursement for patient care is determined by the diagnosis-related groups (DRGs). A DRG is a…

Q: Identify and describe the legal theories the court might use to extend liability to sue nurses

A: Health care ethics or medical ethics and consists of bioethical application in health decisions.…

Q: comprehensive risk assessment for a healthcare facility

A: Assessment is collection, validation and communication of client's data Comprehensive risk…

Q: Tasks that should be completed prior to claim submission include: A Manually sending the claim B…

A: Health insurance Portability and Accountability Act (HIPAA) of 1996 has provided a detailed…

Health Epidemiology

Health is an essential factor for all human beings. For all humans, health is a critical factor. An individual's ability to meet life's challenges and retain his or her capacity for optimal functioning is reflected in his or her condition of health. This needs the physical, mental, and biological parts of one's constitution to maintain a degree of functioning that has a favorable influence and support for one another.