RESPOND WITH YOU OPINION OF THE POST BELOW AND COME UP WITH THREE QUESTIONS. A precursor is a sign or signal that an event may occur in the future. An indicator is a sign or signal that an incident is occurring or has already occurred. In the healthcare industry, there are some challenges that comes from incident detection precursors and indicators. It’s rare that a […]
F. scott fitzgerald: jazz age, roaring twenties, and aspiration of | Literature homework help betopumascholtz How and why do the terms Jazz Age and Roaring Twenties relate to Fitzgerald’s writing? Are there any autobiographical notes in Winter Dreams? If yes, then which? Did you sympathize with Dexter Green in his tangled feelings for Judy Jones? Explain why or why not. What details does Fitzgerald use […]
Baseball, America’s beloved pastime, has a rich history that extends beyond the game itself. One integral aspect of the sport’s evolution is the development of baseball shirts. Chicago Cubs Shirts are a fine example of it. From the early days of wool uniforms to the modern era of high-performance fabrics, baseball shirts have undergone significant changes to enhance players’ comfort and performance on the field. […]
Social media headlines read “Coach Krakus leads volleyball team to league’s championship game for 1st time in coaching career.” Coach Krakus is completing his 13th year as head coach of a co-ed junior league (i.e., 13–15-year-old participants) volleyball team. Yesterday, Coach Krakus’ team won their semi-final game and will be playing in the championship tomorrow night. During this morning’s practice session, a player on the […]
QUESTION ONE:In chapter 9, you read about how both these issues impact professionals from many fields of practice. Select a field OTHER THAN your own from the list below. Do a search in the popular press to an ethical lapse in the news pertaining to a person from that career. Explore this issue, delineate both legal and ethical issues. You should refer to the law, licensure/practice act, and the […]
II 111TH CONGRESS 1ST SESSION S. 773 To ensure the continued free flow of commerce within the United States and with its global trading partners through secure cyber communications, to provide for the continued development and exploitation of the Internet and intranet communications for such purposes, to provide for the development of a cadre of information technology specialists to improve and maintain effective cyber security […]
For this assignment, select one of the scenarios below. Your task is to assemble an interdisciplinary therapeutic team to deliver services in your chosen scenario. Develop a PowerPoint presentation to present to the therapeutic team you have assembled. Determine who the team members are, why you have selected that profession for inclusion as part of the team, the evidence-based interventions you will use, and the […]
SCHEMAS Most everyone has seen criminal trials (both fictitious and real) on TV. You know, then, that the trial starts with opening statements and ends with closing arguments by the prosecution and defense, respectively. For this Discussion, you will examine the advantages and disadvantages of schemas. Be sure to review the Learning Resources before completing this activity.Click the weekly resources link to access the […]
Description Graduate Programs Discussion Boards Discussion Boards (DB) are a key component of online learning. They foster active participation of learners and dialogue with fellow learners and instructors. Graduate-level courses require learners to create original posts to course DBs and to engage in dialogue by responding to posts created by others throughout the course. Original posts and responses should be substantive, and if references are […]
Question 1 (4 points) What is the Myth of Amoral Business? Question 1 options: A) An unpopular view of American business. B) A popular view of American business. C) Reporting of scandals. D) None of the above. Save Question 2 (4 points) The breakdown of the Myth of Amoral business has been signalled by: Question 2 options: A) the reporting of scandals. B) the formation […]
Assignment 1: LASA 2— Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for The Medical Reporter, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
I. How to conduct an investigation. It should include the following elements:
a. Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
b. Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
c. Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
d. Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
e. Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
II. How to develop a correction action plan. The plan may suggest:
a. A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
b. A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
By Saturday, August 24, 2013, deliver your assignment to the M5: Assignment 1 Dropbox.
Use the following file naming convention: LastnameFirstInitial_M5_A1.doc.
|
Assignment 1 Grading Criteria |
Maximum Points |
|
Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity. |
36 |
|
Explained the steps to take to determine who is involved in the complaint. |
32 |
|
Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation. |
32 |
|
Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview. |
32 |
|
Identified the criteria to determine if the allegations are substantiated or unsubstantiated. |
32 |
|
Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary. |
36 |
|
Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted. |
36 |
|
Written Components: Style (8 points): Tone, audience, and word choice Organization (16 points): Introduction, transitions, and conclusion Usage and Mechanics (16 points): Grammar, spelling, and sentence structure APA Elements (24 points): In text citations and references, paraphrasing, and appropriate use of quotations and other elements of style |
64 |
|
Total: |
300 |
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