Reimbursement

The overuse of medical imaging has created a large financial burden. In an effort to reduce unnecessary tests and associated costs, a set of guidelines was created for prescribing providers to adhere by. The appropriate use criteria, in my opinion, is a major step toward a better healthcare system. If providers embrace the criteria, it will result in better patient outcomes both clinically and economically.1 I am confident that the appropriate use criteria guidelines will help me in my clinical…

Receiving an accreditation in joint commission helps the organization understand the importance of health and safety care by providing quality care. Based on the organizations survey they can then determine which accreditations are right for them. According to the joint commission there are many benefits that are entailed with this accreditation starting with patient safety, community confidence, competitive edge a decreased risk of reduction and liability costs (TJC, 2018). Illustrating that…

1. Phillips discusses in, “Clinical Social Workers as Diagnosticians: Legal and Ethical Issues” the changes made to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association which have impacted clinicians. Initially, the DSM was based on the psycho-social model, however, it was later changed to focus on the medical model. The result of this change caused clinicians to have to diagnose individuals and include a diagnosis in most cases. Insurance companies…

future. I have also begun and will continue to evaluate the need for graduate school and what companies can help subsidize the cost. Currently, Google offers a tuition reimbursement program up to $12,000 annually. Though this is an extremely attractive option, other companies like Starbucks are notorious for their tuition reimbursement plans. Thus, in the next year I plan on deciding what the best option is for me, whether that be pursing an MBA with the help of Google or another company, or…

released of any liability down the road. The third party payers can seek lower reimbursement rates and trusts Kaiser is highly invested in preventative care because they are also a health plan. Third party payers make more money if their patients are healthy and out of the hospitals. The higher profit margins of Kaiser along with nonprofit classification give them the ability focus on the patient experience to increase reimbursement. The only downfall of the organization is the stricter…

Financial software developers, such as the following financial software firms, recognize the changing marketplace as an opportunity to introduce powerful new solutions as the health care field shifts from a service fee for service to outcome based reimbursement structure. Allscripts Allscripts distributes a user-friendly, feature-rich patient…

Dennis Nash is a single father living with his mother. He originally worked as a construction worker, but after the housing market crisis he became unemployed and was no longer was able to pay for his mortgage. Dennis and his family were then forcibly evicted by law enforcement and a real estate broker named Rick Carver. They then move into a motel and struggle as Dennis looks for a job. He then begins to work for Rick after he offers him a job that will teach him to get out of his current…

2013). Sepsis increases the length of hospital stay, costs, and morality. Purpose of New Sepsis Screen Tools Implementation In December 2015 Centers for Medicaid and Medicare Services (CMS) announced hospitals would be penalized one percent of reimbursements if they have high rates of Hospital Acquired Infections (HAIs) (Stone, 2015). HAIs have a high risk of sepsis, especially those with weak immune systems. Early diagnosis and treatment…

barriers to the NP carrying out roles in research, education, and leadership (Plager & Conger, 2007). The external barriers are related to public policy such as prescriptive privileges, autonomy versus physician oversight, credentialing, and reimbursement. State regulations often restrict the ability of nurses to provide care legally. State legislation regarding the legal scope of practice for NPs, which defines the activities that a qualified NP may perform, vary widely. Some state…

Mylan obtained the patent and manufacturing rights for the EpiPen injector in 2007. Over the past ten years, Mylan has had to increase the price of the injector, from $100 at the time of obtaining the EpiPen to $608 in 2017, to meet the expense demands of their supply chain. This drastic price increase in this life-saving device has brought scrutiny to the firm as another greedy pharmaceutical giant (Popken, 2016). This increase has caused the firm to fall under investigation by the Federal…