Milestone
Title of Paper 6
The vice president of accounting says to you, the IT director, “This request procedure takes too long. My people know what they are doing, and their systems requests are necessary and important.” She suggests that the IT department bypass the initial steps and immediately get to work on her request. What would you say to her?
The vice president of accounting says to you, the IT director, “This request procedure takes too long. My people know what they are doing, and their systems requests are necessary and important.” She suggests that the IT department bypass the initial steps and immediately get to work on her request. What would you say to her?
Title of Paper
Student Name
SNHU
Title of Paper
Introduction
Anything you see in bold text will be deleted as you work on these sections of this paper. You will most likely write this section last, after you have completed all three milestones. This introduction serves as your introduction for the entire paper. Here, you will write no more than a page to identify the purpose of the paper (why you are writing this), the scope of the paper (a summary of what it covers), and the subject of your paper (the overarching topic).
Part 1: Financial Principles and Reimbursement
Reimbursement Strategies
This section of your paper is no more than half a page. You will use research to define case rates and management utilization. Then you will show how these factors impact pay for performance incentives. (Assume your reader knows what pay for performance is.)
Reimbursement Methods
This section of your paper can easily be written as a chart. You will want to choose methods that are dissimilar enough to allow for comparison. Please use the chart I have provided for this section. (I know you are busy! I’m trying to make your life easier.) You need no further explanation other than the chart.
| Reimbursement Method | Advantages
For Strategic Planning of Operational Performance |
Disadvantages
For Strategic Planning of Operational Performance |
Best Use
(Type of Facility and Why) |
| Method 1 | |||
| Method 2 |
Financial Management Principles
Another Chart! You need no additional information other than what you include in the chart. You will include three of the financial management principles listed within the assignment directions (revenue reimbursement, benchmarking of industry standards, payer-mix breakdown of payers, case rate and utilization rate data) to identify how they are used to evaluate operational performance.
| Financial Management Principle | How It Is Used to Evaluate Operational Performance |
Accounts Receivable
This section is a half-page. You are addressing two main questions: What are at least two challenges associated with collecting payments for accounts receivable? And why must the healthcare organization monitor cash flow and days in accounts receivable?
Teamwork Principles
Another chart! I’m looking for four principles.
| Teamwork Principle Used with Cross-Disciplinary Teams (Research best practices of Cross-Disciplinary Teams) | A Challenge Presented By This Principle and Why |
Maximizing Reimbursement
This section is a half-page. Do healthcare organizations, in general, adequately utilize case rates and management utilization to maximize payment from payors?
Part 2: Federal and State Payment Systems
Federal and State Regulations
This section is no more than a half-page. Pick two recent federal or state regulations that present the most concern for healthcare leaders. Why do healthcare leaders need to be concerned about these regulations?
Reporting Requirements
This section is no longer than a page. Review CMS.gov. What are some items that are required to be reported for CMS? What are two opportunities (benefits for the healthcare organization and/or American health) and two challenges (concerns within the healthcare facility) for healthcare leaders in meeting the reporting requirements you described?
Compliance Standards
This section is no longer than a half-page. Return to your Financial Management Principles section on part one of this project. Look more closely at two of those principles and expand upon how those principles ensure compliance with CMS standards.
Government Payer Types
This section is no longer than a half-page. Identify two strategies you would recommend organizations implement to receive full and timely reimbursement on claims from CMS.
Part 3: Third-Party Payment Systems
Healthcare System Reimbursement
This section is no longer than a half-page. Choose a third party payor (Aetna, Blue Cross, Kaiser Permananete are all big ones). Identify two impacts a third party payor has on a healthcare organization. (Why should the healthcare organization care about meeting the requirements of the third party payor?)
Reporting Requirements
This section is no longer than a page. Using the same payor, what are some items that are required to be reported to that payor? What are two opportunities (benefits for the healthcare organization and/or American health) and two challenges (concerns within the healthcare facility) for healthcare leaders in meeting the reporting requirements you described?
Compliance Standards
This section is no longer than a half-page. Return to your Financial Management Principles section on part one of this project. Look more closely at two of those principles and expand upon how those principles ensure compliance with your third party payor standards.
Reimbursement Methods
This section is no longer than a half-page. Identify two strategies you would recommend organizations implement to receive full and timely reimbursement on claims from your third party payor.
Part 4: Operational and Strategic Planning in Healthcare
Pay-For-Performance Incentives
This section is no longer than a half-page. What are two operational recommendations you would make to improve performance measures so your organization can maximize reimbursement? Please explain how these two recommendation will help to improve performance measures.
Operational Performance Measures
This section is no longer than a half-page. What are two performance measures that should be benchmarked so reimbursement is maximized? Why?
Teamwork and Strategic Planning
Use the chart below for this section. Please select two techniques.
| Collaborative Teamwork Technique | How It Will Help Maximize Reimbursement |
Communicating Strategic Planning Across Teams
This section is no longer than a half-page. Identify and explain two methods you would use to communicate information to key stakeholders. For example, how would you communicate the same decision to patients, administrative staff, and clinicians?
Financial and Reimbursement Strategies
Use the chart below for this section.
| ++++++++++++ | Cash Flow | Days in Accounts Receivable |
| Recommendation for Low Performing System | What should the system do to improve cash flow? | What should the system do to improve Days in A/R? |
| Recommendation for High Performing System | What should the system do to improve cash flow? | What should the system do to improve Days in A/R? |
References
Per APA requirements, references are written in alphabetical order. Only the first line of each reference is indented. See the course for more on how to write references in APA.
You will want to update this page with every milestone.
