Explain the Tricare Program and basic eligibility requirements

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Lab Assignment: Tricare and champva presentation

1. Imagine you are working as a trainer for new registration specialists at ABC Hospital’s primary care clinics. You have been asked to create a presentation giving a basic overview of the Tricare and CHAMPVA programs. For this assignment, create a Power Point presentation that includes 6-9 slides along with your speaker notes. Use the list of eligibility requirements you captured from the two activities in the lesson.

You should include the following information within your presentation:

  1. Explain the Tricare Program and basic eligibility requirements
  2. Describe three Tricare plans within the program
  3. Explain the CHAMPVA Program and Eligibility Requirements
  4. Explain the difference between a par and non-par provider for these military plans
  5. Describe some covered services of these military plans and services that may require authorization.

Lab Assignment: Workers’ Compensation Case Study Worksheet

2.  Download and complete the Workers Compensation worksheet.Preview the document

Once you have completed the case studies, name your file “Workers Compensation”

Should Samuel file a disability insurance claim?

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Lab Assignment: Workers’ Compensation Paper / Lab Assignment: Disability Determination

Disability Determination Assignment

Name: Click or tap here to enter text. Date: Click or tap to enter a date.

Part One: Disability Scenarios

For this portion of the assignment, you will read the scenario and the answer the questions that follow.

Scenario One

Stacey was working as a hostess for a popular restaurant and became ill and was sent home. She decided to go the doctor for treatment and it was determined that she had strep throat. She was advised by the doctor to stay home for three days and then return to work.

1. Does this qualify for any type of disability claim? Click or tap here to enter text.

2. Why or why not? Click or tap here to enter text.

Scenario Two

Samuel was a truck driver for many years and the company he worked for had very good benefits. Samuel began to have some health problems that led him to make an appointment with the doctor. He was experiencing dizziness, sweating, extreme thirst and some weakness. Upon his visit to the doctor and after several tests, Samuel was found to have Diabetes. He was advised to remain off work for several weeks so his blood sugars could get under control. The plan was to manage by oral medication. Samuel was still off work after 6 weeks of treatment and he began to explore his benefit options. The doctor advised him he would be able to return to work in another two weeks.

3. Should Samuel file a disability insurance claim? Click or tap here to enter text.

4. If so would this be long or short term disability? Explain your answer in detail. Click or tap here to enter text.

Scenario Three

Martin was feeling ill one day and collapsed on the floor while at home talking with his wife. He was transported by ambulance to the hospital and was found to have suffered a stroke. Martin was paralyzed on his left side and was unable to use his left arm and leg. He was going to need extensive therapy. He worked as a carpenter for a local building company and his work was very physically demanding. After months of treatment with some improvement Martin began to explore his options. He still needed to use a walker and did not have full use of his arm. His company did not offer any disability plans and he had almost exhausted all his sick time. The doctors felt, Martin was unable to be gainfully employed.

5. What type of disability should Martin apply for? Click or tap here to enter text.

6. What steps must he take to apply? Click or tap here to enter text.

Scenario Four

Sherry was diagnosed with Lupus and spent several months in treatment for her condition. The doctors told her she may be able to return to work, but she would need several months of treatment. Sherry worked for a large hospital corporation for over 25 years and she had built up over 3 months of sick time. She knew she qualified for the Family Medical Leave benefit, but this would take from her sick time, but protect her job. Her condition prevented her from working and after three months of not working, Sherry sat with a human resource representative to explore her options. The doctor told her she would most likely be off work for another six to as much as 12 more months.

7. What type of disability do you think the HR representative advised Sherry to apply for? Click or tap here to enter text.

8. Does Sherry meet the requirements to apply for Social Security Disability? Why or why not? Click or tap here to enter text.

Disability Determination

Assignment

Name:

Click or tap here to enter text.

Date:

Click or tap to

enter a date.

Part One

:

Disability

Scenarios

For this

portion of the assignment, you

will read the scenario and the answer the questions that follow.

S

cenario One

Stacey was working as a hostess for a popular restaurant and became ill and was sent home. She

decided to go the doctor for treatment and it was determined that she had strep throat. She was

advised by the doctor to stay home for three days and then return to work.

1.

Does this qualify for any type of disability claim?

Click or tap here to enter text.

2.

Why or why not?

Click or tap here to enter text.

Scenario Two

Samuel wa

s a truck driver for many years and the company he worked for had very good benefits.

Samuel began to have some health problems that led him to make an appointment with the doctor. He

was experiencing dizziness, sweating, extreme thirst and some weakness.

Upon his visit to the doctor

and after several tests, Samuel was found to have Diabetes. He was advised to remain off work for

several weeks so his blood sugars could get under control. The plan was to manage by oral medication.

Samuel was still off work

after 6 weeks of treatment and he began to explore his benefit options. The

doctor advised him he would be able to return to work in another two weeks.

3.

Should Samuel file a disability insurance claim?

Click or tap here to enter text.

4.

If so would this be long or short term disabilit

y? Explain your answer in detail

.

Click or tap

here to enter text.

Scenario Three

Martin was feeling ill one day and collapsed on the floor while at home talking with his wife. He was

transported by ambulance to the hospital and was found to have suffered a stroke. Martin was

paralyzed on his left si

de and was unable to use his left arm and leg. He was going to need extensive

therapy. He worked as a carpenter for a local building company and his work was very physically

demanding. After months of treatment with some improvement Martin began to explore

his options. He

still needed to use a walker and did not have full use of his arm. His company did not offer any disability

plans and he had almost exhausted all his sick time. The doctors felt, Martin was unable to be gainfully

employed.

5.

What type of

disability should Martin apply for?

Click or tap here to enter text.

6.

What steps must he take to apply?

Click or tap here to enter text.

Disability Determination Assignment

Name: Click or tap here to enter text. Date: Click or tap to enter a date.

Part One: Disability Scenarios

For this portion of the assignment, you will read the scenario and the answer the questions that follow.

Scenario One

Stacey was working as a hostess for a popular restaurant and became ill and was sent home. She

decided to go the doctor for treatment and it was determined that she had strep throat. She was

advised by the doctor to stay home for three days and then return to work.

1. Does this qualify for any type of disability claim?

Click or tap here to enter text.

2. Why or why not?

Click or tap here to enter text.

Scenario Two

Samuel was a truck driver for many years and the company he worked for had very good benefits.

Samuel began to have some health problems that led him to make an appointment with the doctor. He

was experiencing dizziness, sweating, extreme thirst and some weakness. Upon his visit to the doctor

and after several tests, Samuel was found to have Diabetes. He was advised to remain off work for

several weeks so his blood sugars could get under control. The plan was to manage by oral medication.

Samuel was still off work after 6 weeks of treatment and he began to explore his benefit options. The

doctor advised him he would be able to return to work in another two weeks.

3. Should Samuel file a disability insurance claim?

Click or tap here to enter text.

4. If so would this be long or short term disability? Explain your answer in detail.

Click or tap

here to enter text.

Scenario Three

Martin was feeling ill one day and collapsed on the floor while at home talking with his wife. He was

transported by ambulance to the hospital and was found to have suffered a stroke. Martin was

paralyzed on his left side and was unable to use his left arm and leg. He was going to need extensive

therapy. He worked as a carpenter for a local building company and his work was very physically

demanding. After months of treatment with some improvement Martin began to explore his options. He

still needed to use a walker and did not have full use of his arm. His company did not offer any disability

plans and he had almost exhausted all his sick time. The doctors felt, Martin was unable to be gainfully

employed.

5. What type of disability should Martin apply for?

Click or tap here to enter text.

6. What steps must he take to apply?

Click or tap here to enter text.

Perform an Internet search and identify one company where you would like to work.

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Lab Assignment: SS Disability Process PowerPoint

1.  Using the SSDR website, (Links to an external site.)Links to an external site. you are to prepare a 6-8 slide PowerPoint presentation outlining the steps in the disability process. You must include detailed speaker notes.

Name your presentation “SS Disability Process ”

Assignment: Elevator Speech

2.  For the C3P Elevator Speech assignment, you will complete one of the following as directed by your instructor:

  • Option 1: Perform an Internet search and identify one company where you would like to work. Then write a short profile of the company, including its main products, its competitors, and who manages the company. Next, list the qualities you think this employer is looking for in an employee.
  • Option 2: Examine the company profiles of three employers in your local market (provided by your instructor). Reflect on the qualities these potential employers may be looking for in an employee. List qualities you already have and any you may need to work on.
  • note: I am study to be medical billing and coding. I live in San Antonio, Texas. I have no experiment in this field.

What are the different types of cleft lip and palate?

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Lab Assignment: Respiratory Cleft Palate Essay

1. Write a 1-2 page paper about infants born with a cleft lip and palate. Be sure to answer all of the questions below:

  1. What are the different types of cleft lip and palate?
  2. What are some complications that an infant could experience with a cleft lip and palate?
  3. How is it diagnosed?
  4. What is the treatment?
  5. On average, how many surgeries will a child with a cleft lip and palate have to undergo?
  6. What is nasoalveolar molding?
  7. What two CPT codes represent repair of a nasal deformity secondary to congenital cleft lip and/or palate?

When you are finished, name your file “Cleft Palate Essay”

Quality Improvement Strategies

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Project 2: Promoting Health Care Quality

Section 4: Quality Improvement Strategies

Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality. Looking at outcomes, alone, may not tell the “whole story.” For instance, if you are concerned with improving fall rates, evaluating the process—related activities or practices—can help you identify factors that contribute to outcomes and develop strategies for improving them.

For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process.

To prepare:

  • Review the instructions provided in the Learning Resources for creating a process map.
  • With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process.
  • Create a process map using Microsoft Word or PowerPoint.
  • Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created.

To complete:

  • Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue.
  • Finalize your process map, which will be submitted along with the paper.

 

Required Readings

Cookson, D., Read, C., Mukherjee, P., & Cooke, M. (2011). Improving the quality of emergency department care by removing waste using Lean Value Stream mapping. International Journal of Clinical Leadership, 17(1), 25–30.
Retrieved from the Walden Library databases.

This article demonstrates how a process map can be used to identify waste and promote efficiency, particularly in large departments.

Ford, J. H., Wise, M., & Wisdom, J. P. (2010). A peek inside the box: How information flows through substance abuse treatment agencies. Journal of Technology in Human Services, 28(3), 121–143.
Retrieved from the Walden Library databases.

The authors of this article establish the importance of using process maps for improving productivity and information flow.

Abubakker, H. T. (2010). Practical guide to creating better looking process maps. Retrieved from http://www.isixsigma.com/tools-templates/process-mapping/practical-guide-creating-better-looking-process-maps/

iSixSigma’s website offers a practical guide with many tips for creating an easy-to-follow process map.

NHS Institute for Innovation and Improvement. (2010). Quality and service improvement tools: Process mapping—an overview. Retrieved from http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/NHS%20III%20Handbook%20serviceimprove.pdf

The NHS article outlines the importance of process maps and provides a detailed description of how to create a process map.

an explanation of how using a process map could inform and facilitate quality assessment and improvement, including data collection efforts, related to your Course Project

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Using Process Maps for Quality Assessment and Improvement

Given the synergistic relationship between process and outcomes, leader-managers and other team members need to evaluate processes related to care delivery, customer service, and other matters in order to diagnose problems and effectively improve quality.

A process map is a visual representation that illustrates activities and practices as they occur, which serves as a valuable resource for identifying trouble spots. It is important to note that process maps can also be used for evaluation after an intervention has been implemented. For instance, looking at a process map following an intervention may help leader-managers to note discrepancies between what was planned and what is actually being practiced, or to see that a process has in fact improved, even if the outcomes have not met the targets.

In this Discussion, you examine how process mapping could be applied to your Course Project.

To prepare:

  • Review the Learning Resources, focusing on the use of process maps for improving quality and safety.
  • Bring to mind your work on your Course Project thus far. How could you use a process map to diagnose problems and inform strategies for improvement? In addition, think about how using a process map could inform and enhance your data collection efforts.
  • Conduct additional research on this topic to support your thinking.

By Day 3

Post an explanation of how using a process map could inform and facilitate quality assessment and improvement, including data collection efforts, related to your Course Project. Support your response with evidence from the literature.

 

Required Readings

Cookson, D., Read, C., Mukherjee, P., & Cooke, M. (2011). Improving the quality of emergency department care by removing waste using Lean Value Stream mapping. International Journal of Clinical Leadership, 17(1), 25–30.
Retrieved from the Walden Library databases.

This article demonstrates how a process map can be used to identify waste and promote efficiency, particularly in large departments.

Ford, J. H., Wise, M., & Wisdom, J. P. (2010). A peek inside the box: How information flows through substance abuse treatment agencies. Journal of Technology in Human Services, 28(3), 121–143.
Retrieved from the Walden Library databases.

The authors of this article establish the importance of using process maps for improving productivity and information flow.

Abubakker, H. T. (2010). Practical guide to creating better looking process maps. Retrieved from http://www.isixsigma.com/tools-templates/process-mapping/practical-guide-creating-better-looking-process-maps/

iSixSigma’s website offers a practical guide with many tips for creating an easy-to-follow process map.

NHS Institute for Innovation and Improvement. (2010). Quality and service improvement tools: Process mapping—an overview. Retrieved from http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/NHS%20III%20Handbook%20serviceimprove.pdf

The NHS article outlines the importance of process maps and provides a detailed description of how to create a process map.

Describe member services and incentives.

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Health plan internet search

Internet Search

 

Access the Internet and locate a health insurance company’s (e.g. UnitedHealth, Aetna, etc.) website. Write a three- to five-page double-spaced paper (excluding title and reference pages), addressing the following:

· Describe member services and incentives.

· Discuss new/current/upcoming technology.

· Examine provider network and outreach.

· Explain the insurance company’s commitment to excellence and quality.

· List its accreditation and/or certification.

· Generate two recommendations for improving the company’s member services and/or website.

The Internet Search assignment

· Must be three to five double-spaced pages in length (excluding title and references pages) and formatted according to APA style as outlined

· Must include a separate title page with the following:

· Title of paper

· Student’s name

· Course name and number

· Instructor’s name

· Date submitted

· Must include an introduction and conclusion (Links to an external site.)Links to an external site. paragraph.

· Must use at least three scholarly, peer-reviewed, and/or other credible sources in addition to the course text.

· The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment. Be sure to integrate your research (Links to an external site.)Links to an external site. rather than simply inserting it.

· Must document all sources in APA style as outlined here (Links to an external site.)Links to an external site. and here (Links to an external site.)Links to an external site..

· Must include a separate references page (Links to an external site.)Links to an external site. that is formatted according to APA

Distinguish the roles of Medicare and Medicaid managed care plans in the healthcare delivery system.

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Medicare/Medicaid Managed Care Plans

Write a three- to five-page double-spaced paper (excluding title and reference pages), addressing the following:

  • Distinguish the roles of Medicare and Medicaid managed care plans in the healthcare delivery system.
  • Assess the similarities and differences between Medicare and Medicaid managed care plans by comparing (a) strengths, weaknesses, and incentives; (b) commitment to access; and (c) risks to the consumers.
  • Synthesize two recommendations for improvement, including your justification, of each managed care plan. (You should have a  total of four recommendations for both Medicare and Medicaid managed care plans.)

The Medicare/Medicaid Managed Care Plans assignment

  • Must be three to five double-spaced pages in length (excluding title and references pages) and formatted according to APA style
  • Must include a separate title page with the following:
    • Title of paper
    • Student’s name
    • Course name and number
    • Instructor’s name
    • Date submitted
  • Must include an introduction and conclusion (Links to an external site.)Links to an external site. paragraph.
  • Must use at least three scholarly, peer-reviewed, and/or other credible sources in addition to the course text.
    • The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment. Be sure to integrate your research (Links to an external site.)Links to an external site. rather than simply inserting it.
  • Must document all sources in APA style as outlined here (Links to an external site.)Links to an external site. and here (Links to an external site.)Links to an external site..
  • Must include a separate references page (Links to an external site.)Links to an external site. that is formatted according to APA style

Managed Health Care Quality

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Prep for Final Paper

This assignment is designed to guide you as you start your research for the Final Paper. Review the requirements for your Final Paper. Then, use the following guide as you write your assignment for Week Three:

  • Final Paper Prep: For the Final Paper, you are to choose an emerging managed care delivery model, Accountable Care Organizations, or Patient-Centered Medical Homes. For this assignment, you will complete section two of your Final Paper – Managed Health Care Quality – to address how the selected emerging managed healthcare delivery model has done to improve quality of care.
  • Annotated Bibliography: Provide an annotated bibliography of at least five of the required ten scholarly sources you will be using to write your Final Paper. An annotated bibliography starts with your source that is in APA format and followed by a brief descriptive and/or evaluative paragraph about your source. Follow the guide provided here

The Prep for Final Paper assignment

  • Must be three to five double-spaced pages in length (not including title and references pages) and formatted according to APA style
  • Must include a separate title page with the following:
    • Title of paper
    • Student’s name
    • Course name and number
    • Instructor’s name
    • Date submitted
  • Must use at least three scholarly, peer-reviewed, and/or other credible sources in addition to the course text.
    • The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment. Be sure to integrate your research (Links to an external site.)Links to an external site. rather than simply inserting it.
  • Must document all sources in APA style as outlined here (Links to an external site.)Links to an external site. and here (Links to an external site.)Links to an external site..
  • Must include a separate references page (Links to an external site.)Links to an external site. that is formatted according to APA style

Using research to help you form an opinion, which form of capital (social or human capital) do you feel will have a greater influence over resources accessible to the abused? 

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 Social Versus Human Capital

This week’s first discussion forum will focus on the population of abused individuals. Abuse is a pervasive problem in our society. Although the forms of abuse, as well as the intensity and duration can vary from case to case, each abused person is tasked with dealing with the scars left from the abuse.  As you can imagine, this task can be very challenging to say the least. Using research to help you form an opinion, which form of capital (social or human capital) do you feel will have a greater influence over resources accessible to the abused?  Discuss which form of capital you would rely on for emotional support and help through difficult times if abused.  Explain your rationale. Chapter 3 of the course text defines these terms in more detail.

Your initial contribution should be 250 to 300 words in length. Your research and claims must be supported by your course text and at least one other scholarly source.  Use proper APA formatting for in-text citations and references as outlined in the Ashford Writing Center.