Archive for category: My Nursing Writer

732.2.1: Reimbursement Methodologies – The graduate describes and compares contemporary healthcare reimbursement methodologies and systems utilized in the United States.

732.2.3: Voluntary Healthcare Insurance Plans and Managed Care -The graduate describes key components of private, commercial, and Blue Cross and Blue Shield insurance plans and evaluates how various insurers use coding in the billing process.
732.2.4: Government-Sponsored Healthcare Programs—Including Medicare and Medicaid – The graduate evaluates and explains various government-sponsored healthcare programs and recognizes the impact that government-sponsored healthcare programs have on the healthcare system in the United States.
732.2.5: Government-Sponsored Healthcare Programs—Other Components and Methods – The graduate evaluates and explains components and methods of non-Medicare/non-Medicaid government-sponsored healthcare programs; and recognizes the impact that government-sponsored healthcare programs have on the healthcare system in the United States.
732.2.6: Ambulatory Reimbursement Systems – The graduate evaluates and explains the structures and components of and performs payment calculations for outpatient healthcare reimbursement in healthcare
The healthcare reimbursement system in the United States is complex. The health informatics professional needs an understanding of the basic principles of the third-party payer system and the many options that are available to citizens through government-funded healthcare programs. Private and commercial insurance companies and Blue Cross and Blue Shield plans offer a different menu of options to their clients. One issue is certain: All third-party payers are interested in decreasing healthcare costs while improving quality and controlling access to unneeded services.

This task will allow you to examine the complexity of the healthcare reimbursement systems and begin to compare the similarities and differences between them. To complete this task, read the attached “A Lifetime of Healthcare Services,” which is a case scenario about a woman named Sophie. Then create a multimedia presentation, diagram, table, or other illustration comparing the differences and similarities among the various insurance options and reimbursement systems that were used to pay for Sophie’s medical care throughout her lifetime.

You are explaining these reimbursement systems from the perspective of a billing department manager training two new staff members. You believe that if you can explain these systems with a real patient, it will be easier for your new staff to understand the various requirements of these reimbursement systems.
A. Compare Sophie’s health insurance options for each of the five phases of her life.
1. Recommend the health insurance option that would provide the best coverage to meet Sophie’s needs during each phase.
a. List the elements of each plan you recommended.
b. Discuss the reimbursement requirements of each plan you recommended.
c. Discuss restrictions to each plan you recommended.

B. If you use sources, include all in-text citations and references in APA format.
Attachment: A lifetime of Healthcare Services

A Lifetime of Healthcare Services

Phase 1
When Sophie was first married, her husband worked in a meat packing plant. His job
offered an optional health insurance package that could cover Sophie’s husband, Sophie,
and their family. Sophie did not have a job; she stayed home to care for their five children
and an elderly parent. Many years passed. Sophie and her husband raised their children,
and her elderly parent died. Sophie’s husband looked forward to retirement.
Phase 2
Sophie’s husband died before he reached retirement age. His company offered his benefits
plan to Sophie, which she could enroll in indefinitely if she chose to do so. This plan would
include good drug benefits. The insurance plan through the company had become a
managed care plan over the years. Sophie decided to remain with her husband’s insurance
plan.
Phase 3
Sophie turned 65. She was on a tight budget and did not like the idea of paying a monthly
premium. However, she wanted her insurance to provide many physician and service
options. She also wanted a good drug coverage plan.

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Identify and discuss the 8 reasons why transcultural nursing is a necessary specialty, according to Madeleine Leininger

 

This week’s readings deal with the foundations of transcultural nursing. In your Module 1 paper, you will address the following questions after reviewing chapter 1, 2, and 4 in your textbook:

Identify and discuss the 8 reasons why transcultural nursing is a necessary specialty, according to Madeleine Leininger (page 6).
In your own words, describe the meaning of cultural diversity. Then relate its relationship to the field of nursing.
In your own words, explain three ways that you provide culturally sensitive care to your patients.

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Required course materials:

Transcultural Concepts in Nursing Care, Joyceen S. Boyle & Margaret M. Andrews, (2015), 7th edition.

Provide doi for all journals

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

APA 6th edition formatting, citations and references.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

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Determine the fundamental ways in which the NCAA’s ethics program failed to prevent the scandals at Penn State, Ohio State, and the University of Arkansas.

Describe the business ethics issues and definitions, theories, and frameworks important to organizational ethical decision making and the role of a human resource professional.
Read “Case Study 6: National Collegiate Athletic Association Ethics and Compliance Program,” located on page 444 of the textbook.

Write a four to six (4-6) page paper in which you:

Determine the fundamental ways in which the NCAA’s ethics program failed to prevent the scandals at Penn State, Ohio State, and the University of Arkansas. Support your response with one (1) example from each of these schools’ scandals.
Examine the principal ways in which the leadership of the NCAA contributed to the ethical violations of Penn State, Ohio State, and the University of Arkansas. Support your response with one (1) example from each of these schools’ scandals.
Predict the key differences in the scenarios that occurred at Penn State, Ohio State, and the University of Arkansas if an effective ethics program was in place. Provide a rationale for your response.
Postulate on two (2) actions that the NCAA leadership should take in order to regain the trust and confidence of students and stakeholders.
Recommend two (2) measures that the HR departments of colleges and universities should take to prevent similar incidents from occurring in the future. Provide a rationale for your response.
Use at least three (3) quality academic resources in this assignment. Note: Wikipedia and other similar Websites do not qualify as academic resources.
Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:

Describe the business ethics issues and definitions, theories, and frameworks important to organizational ethical decision making and the role of a human resource professional.
Determine the role of stakeholder interests, the interrelationship of ethics and social responsibility, and the role of corporate governance in ethics.
Analyze scenarios to determine the ethical character of decisions made and the related impact on the organization.
Write clearly and concisely about issues in ethics and advocacy for HR professionals using correct grammar and mechanics.
Use technology and information resources to research issues in business ethics and advocacy for HR professionals.

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Based on the description, construct a hierarchical organizational chart indicating the appropriate lines of authority and responsibility.

Organizational Chart
For this assignment you will need to develop a hierarchical organizational chart in Microsoft Word. Your chart should fit on a single page.

Complete the following.

Study the following description of the HIM Department.
Based on the description, construct a hierarchical organizational chart indicating the appropriate lines of authority and responsibility.
Include employee name, credentials, and title if known.
Indicate the number of employees reporting to each individual.
HIM Department Description

Peggy Carson, RHIT, is the Director of the HIM Department at General Hospital. The health care facility has over 500 inpatient beds, an active outpatient department, and 150 skilled nursing beds. She has hired four credentialed professionals to assist her in managing the department.

The transcription unit is busy and under the supervision of Sue Harstad, RHIT. Sue is responsible for three full-time and four part-time transcriptionists.

Discharge analysis is performed by four employees who are supervised by Brooke Anderson, RHIT. These employees also perform retrospective clinical pertinence review. Brooke also supervises the two employees who oversee the physician’s completion responsibilities.

The Coding Section is comprised of six coding specialists who code all inpatient and outpatient records. Claire Herriot, CCS, supervises the coders.

The file Unit includes six employees who utilize a bar coding system for filing and retrieval. They are supervised by Mark Allen, RHIT. Mark also oversees the Release of Information Unit where two employees carefully screen and respond to request for health information.

How to Develop an Organization Chart in Microsoft Word

To access the organization chart function, open a new Word document.

Click on Insert on the menu bar. Click on SmartArt. Click on Hierarchy then choose the styles you would like to try. The first two styles might work the best and they are the most traditional for organization charts. Click on your style choice and then click OK. This will open a new chart for you to edit and fill in. Be sure to save it as you work.

To write text in a box, simply double click on the box. The font will adjust to fit the box as you type. To add boxes, click on the box nearest to the location where you want to add a new box. On the menu bar, click on Add Shape and choose the placement from the list of choices. The box will automatically be added. Continue until you have completed your chart. Don’t forget to save your work.

You may need to adjust your page layout and/or margins, to get your chart to fit on one page.

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IMPLEMENT AND MONITOR NURSING CARE FOR CLIENTS WITH ACUTE AND CHRONIC HEALTH PROBLEMS.Peter Weir is a 39 year old man who has been admitted electively for a bowel resection and temporary colostomy required as a result of complications of Crohn’s disease.

Case Study 3

Peter Weir is a 39 year old man who has been admitted electively for a bowel resection and temporary colostomy required as a result of complications of Crohn’s disease. You have been assigned him and as you are rostered on for the next 4 days on late/early, early/late shifts, will be providing a great deal of his care. You will be required to admit him to the ward, prepare him for surgery and you will be looking after him immediately post op and during the first few days back on the

ward. Click here for more on this paper…….
Click here to have a similar paper done for you by one of our writers within the set deadline at a discounted…His male partner of 15 years, Ross, is very supportive and is there when you admit him but for some reason he interjects and does not let Peter answer questions, instead he answers for him.

1. You have made a care plan for Mr Weir and the first two nursing diagnoses are:

a) Knowledge deficit – care of colostomy (he is worried about how he will care for the colostomy as he has never had this procedure before). He requires education on the procedure related to changing his bag and cleaning. Explain what you will tell him.

b) Body Image Disturbance – He says “This is so disgusting!”, “I hate this!”, “I can never go out again!” reflecting a negative view of his physical appearance. What will you say to him to reassure him?

2. What possible reasons could there be for why Mr Weir’s partner is answering for him and not letting him answer himself?

3. What is consent and what is the role of an Enrolled Nurse in relation to this?

4. Review the ANMC competencies for an Enrolled nurse and identify which one of these domains relates to the area of consent, provide an explanation?

5. Does Ross have a legal and moral right to:

a) stay in Peter’s room all day and all night

b) to advocate for him

c) to make requests on his behalf?

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