Health insurance mandate

describes Medicaid as “a joint federal-state program of health care coverage for low-income individuals, under Title XIX of the Federal Social Security Act. States set benefits and eligibility requirements and administer the program” (Jonas & Kovner, 2015). Medicaid is not a singular one-dimensional program but rather a multi-layered comprehensive piece of legislation that provides an insurmountable amount of funds and resources to make health care more accessible for low-income populations.…

“The diverse network of providers in the Carolinas Healthcare System has 900 care locations to includes academic medical centers, hospitals, healthcare pavilions, physician practices, destination centers, surgical and rehabilitation centers, home health agencies, nursing homes, and hospice and palliative care” (Carolinas Healthcare System, 2015). I am currently working in one of the hospitals. The hospital is a safe haven for the physically and mentally impaired. The hospital is designed…

e-Sourcing solution designed for the unique requirements of the health care supply chain. It also provides the flexibility to source nearly every expense category in a hospital, allowing clients to negotiate contracts during a bidding process. The e-Sourcing process ensures the best terms and value from current and prospective suppliers (Baker et al., 2000; Dominick, 2011; Medpricer, 2015; Slocumb & Grant, 2011). However, health care providers are facing more pressure than ever to save…

Even though senior homes are extremely popular, they are not everyone’s cup of tea. Some seniors and their family prefer home care options. Home care allows seniors to receive the care they need without having to relocate from their home to a new facility. With all the convenience that senior home care offers, it can be costly. People tend to save for years in advance in order to afford these services. However, a sudden emergency may require the immediate need for senior home care. Paying for…

network of various health care providers. It includes profit and non-profit private owned hospitals, government hospitals, urgent care centers, primary care practices, specialty treatment centers, hospice services, and pharmacies. Majority of Americans pay for medical services through private insurance provided by theirs, their spouse or parent’s employer, which they have to pay a partial monthly premium cost. Individuals with low income are eligible to can buy private insurance exchange…

offender may face millions of dollars in fines, but you still allowing them to practice and generate income. Also if they have a private practice then they have the ability to hire a new provider that will have the ability to bill state and federal insurance possibly leading further fraud and continued financial gain through the entity that they are no longer personally and professionally associated. However, believe a civil or…

Health care administrators direct the operation of health systems, hospitals, and other sorts of businesses. They are responsible for staff, programs, services, budgets, facilities, collaborations with other organizations, and other supervisory functions. Unlike physicians, health care administrators do not interact with patients directly daily. Rather, they help shape policy, act as change agents, and direct health-related industries by supporting the improvement of the health care system to…

using both primary and secondary patient data, insurance, and provider and the revenue cycle is vital in creating compliant and efficient reimbursement processes. The revenue cycle is divided into four which are preclaims activities, claims processing, account receivable and claims reconciliation and collection. The preclaims submission is the first process in the cycle which begins with patient case management and preregistration such as collection insurance information before patient arrives…

The Office of the Inspector General (OIG) was established in 1976 with the goal to restrain frauds, abuses, and wastes in healthcare services for Medicare, Medicaid, and other Health and Human Services. OIG advises healthcare organizations to follow the OIG guidelines on establishing effective compliance and ethical policies. The policies will help organizations to identify and stop inappropriate performance from happening. The content of each policy will be determined by individual healthcare…

patients/residents, healthcare providers, and taxpayers, a $25 billion cost to be exact. This is the estimated amount that avoidable readmissions cost the nation on a yearly basis and is one of the largest contributors to the enormous growth in national health care costs. Readmissions are the result of several difference aspects from incomplete treatment, poor post-acute care, lack of coordination in discharge planning, or even the unavailability of social supports. Recently the Center for…