Reimbursement

patients that would be more financially beneficial to be cared for by a physician. Nurse practitioners continuing to provide high-quality care will be of utmost importance in aiding the reform of the current laws that deter autonomy and full reimbursement of nurse practitioners. Nurse practitioners need to be aware of the changes that their peers are attempting to make and support them in their efforts. We must all advocate for change, especially the changes that will be of benefit to our…

Introduction With all the changes that have been recently made in healthcare, including how it is delivered to the general public, organizations and businesses are searching for better, more effective means of healthcare delivery. Challenges such as preventative care, healthcare accessibility, healthcare system abuse, and the need to reduce hospital readmissions are being examined for possible solutions. One of the solutions they discovered is the use of Community Paramedicine and Community…

Competencies The Clinical Informatics Registered Nurse (CI) responsible for the implementation of the tele-psychiatry program should demonstrate Quality and Safety Education for Nurses (QSEN) graduate-level competencies to assure a successful implementation that improves quality and safety. The QSEN graduate-level competencies were developed to assure graduate-level nurses are able to demonstrate the skills and attitudes required to improve quality and safety in their workplace. In 2012, the…

commanders to properly and sufficiently run and manage their organizations. Having consistent services, quality, keeping up with consumer demands and proper reimbursement is a key to survival. I think we all can agree that having a paper based system has the power to complicate the quality of our services, organization, consistency and reimbursement. From setting a new appointment for an established patient, to properly processing payments, electronic health records (EHR) have the power to store…

Traditionally the discharge process has been handled by nursing and a nurse case manager. Patients with pulmonary disease, acute or chronic are a significant part of hospital readmission rates. Overall, patients with one respiratory disease process pneumonia, can account for 38.5 percent of hospital readmissions. (Dharmarajan et al., 2013) The needs of discharged patients are not being met up to 81% of patients needing assistance with basic functional needs failed to receive home care referrals…

with the solo practitioner are going by the way side. Physicians are faced with increasing government regulations, ever-changing insurance mandates and higher operating costs. With the ACA tying the physicians’ performance into variable payment reimbursement, maintaining the bottom line will prove more and more difficult. In 2009 the government passed the Health Information Technology for Economic and Clinical Health (HITECH) Act to support the widespread use of Electronic Health Records (EHR)…

practice was focused on treating Medicaid and Medicare patients. • Health Care Financing Administration 1500 Forms contain the patients identifying information, Medicaid or Medicare identification number for the provider and the procedures that are reimbursement is being filed for. • Dr. Krizek voluntarily participated in the Medicare and Medicaid programs. • Blanka Krizek filed for forty-five to fifty minute psychotherapy session whenever Dr. Krizek saw a patient, regardless of what the…

children of service members who have died on active duty while serving their country after September 10, 2001. Eligible family members may receive up to 36 months of 100 percent reimbursements for three categories. School fees and tuition is fully covered for those who attend public schools as in-state students. The reimbursements for those who those attend private schools are capped at a preset maximum amount that is allowed academic year. There is also a monthly housing allowance and books and…

A. Analyze one federal government payer program for healthcare services making an impact on today’s healthcare ecosystem. “The United States has a unique system of health care delivery and it is unlike any other system in the world” (Ch. 1, n.d.). Most other countries around the world have a form of health care that is run by the government and paid for through taxes. In the U.S., one must enroll through an employer, agent, etc., and most pay monthly premiums to be able to have access to…

same facility to create a competitive advantage. Many smaller practices are now integrating with larger healthcare systems and forming legal entities such as Accountable Care Organizations to diversify services, share the expenses and maximize reimbursements. An example of this service can be a primary care facility that have a specialist on staff, and a pharmacy where patients can get treatment and buy their medication all in the same…