Kinns The Medical Assistant 13th Edition Chapter 16 P 348460

Kinns The Medical Assistant 13th Editionchapter 16 Patient Accounts

Kinn’s The Medical Assistant, 13th Edition Chapter 16: Patient Accounts, Collections, and Practice Management PROCEDURE 16-1: PERFORM ACCOUNTS RECEIVABLE PROCEDURES FOR PATIENT ACCOUNTS: CHARGES Scenario 1: Ken Thomas is a returning patient of Dr. Martin. He is being seen for hypertension (ICD-10-CM;I10). He makes his $50 copayment at the time of the office visit. BLUE CROSS BLUE SHIELD 1234 Insurance Place Anytown, Anystate Claim Number: Group Name: ABC Company Group Number: 55124T Employee: Ken Thomas Patient: Ken Thomas SSN: Prepared by: M. Smith James Martin, M.D. Prepared on: 07/04/20XX Walden-Martin Family Medical Clinic 1234 Anystreet Anytown, Anystate PATIENT RESPONSIBILITY Amount not covered: 0.00 Co-pay amount: 0.00 Deductible: 0.00 Coinsurance: 64.61 Patient’s Total responsibility 64.61 EXPLANATION OF BENEFITS DOS CPT/HCPCS Charge Amount Not Covered Reason Code PPO Discount Covered Amount Ded Amount Copay Paid at Payment Amount 06/03/20XX ......% 91./03/20XX ......% 32./03/20XX ......% 60./03/20XX ......% 38./03/20XX ......% 36.48 TOTAL 465.......44 Total Payment Amount 258.44 CBT CODE Reason Code 99204 OFFICE/OUTPT VISIT E/M NEW MOD-HI SEVERIT 48 CON DISCOUNT/PT NOT RESPONSIBLE 94375 RESPIRATORY FLOW VOLUM LOOP 94060 BRONCHOSPSM EVAL SPIROM PRE and POST BRON 94664 AEROSOL/VAPOR FOR INHAL; INT DEMO and EVAL 94760 NONINVASIVE EAR/PULSE OXIMETRY-02 SAT If you have any questions, call Blue Cross Blue Shield at ( Ledger: Blue Cross Blue Shield ID # KT Group # 55124T Subscriber: Ken Thomas Ken Thomas 398 Larkin Avenue DOB: 10/25/1961 Anytown, Anystate Date Service Description Charges Payments Adjustments Balance 06/03/20XX ../03/20XX ../03/20XX ../03/20XX ../03/20XX ..00 Ledger Summary: Scenario 2: Martha Bravo is seeing Dr. Walden for the first time for hypothyroidism (ICD-10-CM; E03.9). She makes the $30 copayment at the time of the office visit. Name: Martha Bravo Address: 1234 Anywhere Station Anywhere, Anystate 12345 Contact #1: ( Contact #2: ( Emergency Contact: John Bravo ( SSN: DOB: 1/23/56 Health Insurance Information: Carrier: Aetna Subscriber: Martha Bravo Subscriber DOB: 1/23/56 ID #: XEK Group #: X1000 Effective Date: 1/1/20XX Employer Information Name: Malibu Gardening Contact: ( Ledger: Health Insurance Carrier: ID #: Group #: Subscriber: Patient name Address DOB: Date Service Description Charges Payments Adjustments Balance Ledger Summary: Objectives Writing objectives is a critical part of strategic planning. Your objectives must be clear statements detailing what will be accomplished, in what time frame, and evaluated against what standard. Peter Drucker stated in The Practice of Management that, "objectives are not fate; they are direction. They are not commands, but they are commitments. They do not determine the future, they are the means by which the resources and energies of the operation can be mobilized for the making of the future" (p. 102). What Makes a Good Objective? There are a number of characteristics of good objectives: 1. Objectives should be clear and concise. Simply state what the objective and avoid long, flowery prose. 2. Objectives should be in written form. By writing your objectives you can reduce the possibility of misinterpretation or misunderstanding. 3. Objectives should name specific results. Make it clear how the results will be evaluated - "1,000 females of child-bearing age who smoke will be counseled" instead of "a large number of women who smoke" or "an acceptable level of patient services" should be used to clearly state what results are sought. 4. Objectives should be time-sensitive. Objectives can be for the short-run or long-run but the timeframe should be indicated. This provides not only a deadline but also sets the time for the final evaluation of the strategy. 5. Objectives should be stated in measurable terms. Avoid ambiguous phrases such as "increase patient satisfaction" or "improve staffing" which don't allow for measurement. How much increase? How much improvement? 6. Objectives should be attainable, yet challenging. It doesn't do any good to write objectives that no organization can ever accomplish or objectives that can be reached with minimum effort. In healthcare, we tend to focus on four different types of objectives: 1) services offered; 2) staffing; 3) services reimbursement, donations, and funding; and 4) constituents served. Before you write your objectives, consider these questions: 1. What areas will your objectives focus on - patients, services, revenues, staffing, other? 2. What needs to happen for your program to be successful? How many people served? Levels reached? Etc. 3. When do you want this to happen? By what specific date? Reference: Drucker, P. (1954). The practice of management . New York: Harper Collins. Guidelines for Evaluating Your Objectives: Once you have written your objectives, evaluate them using the following: 1. Is each objective relevant to the basic purpose of your organization (look back on your Mission and Vision statements) 2. Is each objective practical? 3. Does each objective challenging? 4. Is each objective stated in measurable terms? 5. Do you have a specific date for completion in each objective? Rasmussen Personal Support Center, call toll-free, 24/7: 1-86 Strategy and Action Planning Identify the strategies (how things will be accomplished). a. To develop (or refine) strategies, clearly describe how the effort will bring about the mission and objectives. Identify for each: i. The levels to be targeted ( i.e., individuals, families and kinship groups, organizations and sectors, and/or broader systems.) What different levels of your problem or goal will you target? ii. For each strategy, consider if it will be universal (i.e., includes all of those who may be at risk or may benefit; e.g. all children and youth) or targeted (i.e., targets those who may be at greater risk for the problem; e.g., youth with a history of violence) iii. The personal and environmental factors to be addressed by the initiative · Personal factors may include: knowledge, beliefs, skills, education and training, experience, cultural norms and practices, social status, cognitive or physical abilities, gender, age, genetic predisposition · Environmental factors may include: social support, available resources and services, barriers (including financial, physical, and communication), social approval, policies, environmental hazards, living conditions, poverty, and disparity in status What personal factors related to your vision and mission are common among those affected by the problem and those maintaining it? What environmental factors related to your vision and mission are common within your targeted community? iv. Those who can most benefit and contribute and how they can be reached or involved in the effort · Targets of change: those who may at particular risk for the issue or whose actions are critical for success. For you, who would this include? · Agents of change: those who may be in a position to contribute to the initiative, including targets of change. Who would this include? · Community sectors: through which targets and agents of change can be reached or involved v. Behavioral strategies to be used. Approaches may include: · Providing information and enhancing skills (e.g., conducting a social marketing campaign to educate people about the problem or goal and how to address it) · Modifying barriers, access, exposures, and opportunities (e.g., increase availability of affordable childcare for those entering work force) · Changing the consequences (e.g., encourage housing developers to create green spaces and mixed income development) · Enhancing services and supports (e.g., increase the number of public health centers that provide dental care) · Modifying policies and broader systems (e.g., change business policies so that employees can get time off to care for their sick children) vi. Review the strategies and comment on their appropriateness to the situation and sufficiency in addressing the mission and objectives. Review the strategies for: · Consistency with the overall vision, mission, and objectives · Goodness of fit with the resources and opportunities available · Anticipated resistance and barriers and how they can be minimized · Whether those who are affected are reached · Whether those who can contribute are involved Any changes? b. Develop (or refine) the action plan by stating the specific community/system changes to be sought that will result in the accomplishment of your goals and objectives i. For each strategy, identify specific community and system changes (i.e., new or modified programs, policies, and practices) to be sought. ii. After compiling a list of potential changes, review each candidate community or system change and rate it on two dimensions: · Importance to the mission (1=not at all, 5=very); and · Feasibility (1=not at all, 5=very) iii. Secure a formal decision from the group on what community or system changes (intervention components and elements) will be sought (or implemented), with priority given to those changes with high importance and high feasibility Related resources: Our Model of Practice: Building Capacity for Community and System Change Obtaining Feedback from Constituents: What Changes are Important and Feasible Providing Information and Enhancing Skills Overview of Tactics for Modifying Access, Barriers, and Opportunities c. Identify action steps for one key community/system change in the action plan (who is going to do what by when). Describe: i. What specific change (e.g., in program or policy) or aspect of the intervention that will occur? ii. Who will carry it out? iii. When the intervention will be completed or for how long it will be maintained? iv. Resources (money and staff) needed/available? v. Communication - who should know what about this? Related resources: Developing an Action Plan Identifying Action Steps in Bringing About Community and System Change Designing Community Interventions d. Evaluate critically the appropriateness of the action plan (i.e., the activities or community/system changes to be implemented). Use the criteria that follow: i. Completeness - Are all the intended activities or community/system changes included in your plan? Are a wide variety of strategies and sectors utilized? ii. Clarity - Is it apparent what will be done and who will do what by when, to bring about change? iii. Sufficiency - If all that is proposed were accomplished, would it meet the group's mission and objectives? If not, what additional changes need to be planned and implemented? iv. Resources (money/staff) needed/available? v. Currency - Does the action plan reflect the current work and situation? vi. Flexibility - As the plan unfolds, is it flexible enough to respond to new opportunities, barriers, and changes in the community? Can it be modified as objectives are accomplished or goals adjusted? Modify your proposed community and system changes and action plans based on your answers (if necessary). Project - Objectives, Strategy, and Action Plan There are three elements to this part of the project: 1. In 1-2 pages, describe 3 objectives for your plan. Using the guidelines provided this week in the lecture, test each objective and include your results with the objectives. 2. After developing a set of objectives, the strategy necessary for accomplishing those objectives must be formulated. Based on the strategy template presented in the lecture, in 1-2 pages describe the elements of your strategy. Here is where you give a synopsis of your plan, what you want to do, how you want to do it, in broad terms. 3. Develop the action plan for your strategic plan. The action, or operational, plan identifies exactly what services will be provided and the exact nature of those services. Write 1-2 pages where you describe your action plan. Be sure to format your references per APA standards and be sure to use in-text citations where necessary. Also, be sure to include a reference page. Activity – Building a Person Brand Personal branding is an essential element for marketing yourself and the skills that make you successful. According to Khedher (2014), "Individuals involved in personal branding develop their human capital by investing in continuous learning; enhance their social capital through visibility and notoriety and access to financial success and economic profitability." Personal branding allows you to stand out from the crowd by projecting a positive image, behavior and actions. Reflect on your personal experiences. Think about the most professional person (fictional or real) that you know. What characteristics make them stand out? After completing these tasks, you must write a personal brand statement. Assignment Guidelines · Length: Minimum of 3 paragraphs (1 paragraph brand statement & 2 paragraphs outlining how the personal brand can guide your career goals) · Format: Times New Roman, font size 12 · Mechanics: APA Style (6th Edition). Must include a cover page and reference page References Khedher, M., (2014). Personal branding phenomenon. Retrieved from: Written Assignment - Customer Relationship Model A customer relationship model attempts to enhance the relationship between the organization and the customer. The goal is to improve customer loyalty while identifying any potential opportunities. In this week's assignment, please find a local healthcare organization that specializes in treating specific patients (ex: cancer, pediatrics, catastrophic injuries) or illnesses. Research the organization, and build a Customer Relationship Model for the organization. The assignment must be submitted in a PowerPoint format (maximum 5 slides) and explains the needs of the customer. The local hospital I’ve chosen is University of Virginia Cancer Center in Charlottesville, VA (closest cancer center to us). Website You might be able to find a better website- this is just a starting point.