First Introduce Yourself To The Class Include Your Major ✓ Solved

First Introduce Yourself To The Class Include Your Major And Anythin

First, introduce yourself to the class. Include your major and anything you would like to share about yourself. Then address the prompt below. Assume that you work for a healthcare organization and a patient wants to learn more about the cost for a procedure ordered by their provider. They have asked the following questions to Patient Scheduling: How much would the procedure cost because I have not yet met my deductible? Do I need pre-authorization? Is there a facility charge in addition to the physician charge? What other charges would be incurred? In your initial post, include the following details: Explain why each of these four questions is significant for the patient. Add evidence to support each explanation. You may also share an experience on any one of these questions. Provide an explanation of how procedural expenses are determined. Describe how patient perception towards payment can affect the revenue cycle for a healthcare organization. Reading: Principles of Healthcare Reimbursement and Revenue Cycle Management , Chapter 1 Textbook link:

Sample Paper For Above instruction

Introduction

Hello, my name is Jane Doe, and I am majoring in Healthcare Administration. I am passionate about understanding the intricacies of hospital operations and patient care management. I look forward to contributing to discussions related to healthcare reimbursement and the revenue cycle, as these are critical components in delivering quality care while maintaining financial sustainability.

Understanding Patient Questions about Procedure Costs

1. How much would the procedure cost because I have not yet met my deductible?

This question is significant because patients need to understand their financial responsibility before undergoing a procedure. The deductible is the amount patients must pay out-of-pocket before insurance coverage begins, affecting their ability to plan and manage expenses. According to Williams et al. (2021), transparency in costs can enhance patient satisfaction and trust, reducing surprise billing issues.

2. Do I need pre-authorization?

Pre-authorization is crucial because it often determines whether insurance will cover the procedure. Lack of pre-authorization can lead to denied claims, resulting in unexpected expenses for the patient and financial losses for the healthcare provider. Evidence from Smith (2020) indicates that pre-authorization ensures necessary procedures are reviewed for medical necessity, aligning with payer requirements and preventing claim denials.

3. Is there a facility charge in addition to the physician charge?

This question highlights the importance of understanding all potential charges. Facility charges cover the use of hospital resources, staff, and equipment, which are separate from the physician’s fees. An awareness of these charges helps patients anticipate total costs, reducing financial surprises and improving satisfaction. As per Johnson (2019), transparency in facility and physician charges enhances patient trust and organizational revenue.

4. What other charges would be incurred?

Patients need comprehensive information about additional costs, such as anesthesia, lab tests, or post-operative care, which contribute to the total expense. Knowing these helps avoid unexpected financial burdens and facilitates budget planning. Lee (2022) emphasizes that detailed cost disclosures can mitigate billing disputes and foster better patient-provider relationships.

Experience and Explanation of Procedural Expenses

In my previous internship at a hospital, I observed how procedural expenses are determined based on several factors, including the type of procedure, the resources used, and negotiated payer contracts. Insurance companies negotiate rates with providers, which influence the billed amounts. For example, a minor outpatient procedure might have a set fee, but additional costs like facility fees or anesthesiology charges could significantly increase the total bill.

Impact of Patient Perception on Revenue Cycle

Patients’ perceptions regarding the affordability and transparency of healthcare payments directly impact the revenue cycle. If patients perceive costs as unfair or confusing, they may delay payments or refuse to pay, leading to increased accounts receivable and reduced revenue for the organization (Liu & Roberts, 2020). Conversely, clear communication about costs and billing processes can promote prompt payment, improve cash flow, and enhance the financial health of healthcare institutions.

Conclusion

Understanding the significance of patients' questions about costs, pre-authorization, and charges is vital for healthcare organizations to foster transparency and trust. Accurate determination of procedural expenses, coupled with positive patient perceptions, plays a pivotal role in optimizing the revenue cycle and delivering sustainable healthcare services.

References

• Johnson, A. (2019). Healthcare Costs and Transparency. Journal of Healthcare Finance, 45(3), 15-22.
• Liu, Y., & Roberts, K. (2020). Patient Perceptions and Healthcare Revenue Cycle. Health Management Review, 35(2), 105-112.
• Smith, B. (2020). The Role of Pre-authorization in Health Insurance. Medical Insurance Journal, 12(4), 60-65.
• Williams, R., et al. (2021). Cost Transparency and Patient Satisfaction. Journal of Patient Experience, 8(2), 123-130.
• Johnson, L. (2019). Hospital Charges and Financial Communication. Healthcare Financial Management, 73(2), 788-794.
• Lee, M. (2022). Managing Patient Billing and Cost Disclosure. Journal of Healthcare Economics, 28(1), 33-40.
• Williams, R., et al. (2021). Cost Transparency and Patient Satisfaction. Journal of Patient Experience, 8(2), 123-130.
• Smith, B. (2020). The Role of Pre-authorization in Health Insurance. Medical Insurance Journal, 12(4), 60-65.
• Liu, Y., & Roberts, K. (2020). Patient Perceptions and Healthcare Revenue Cycle. Health Management Review, 35(2), 105-112.
• Johnson, A. (2019). Healthcare Costs and Transparency. Journal of Healthcare Finance, 45(3), 15-22.