Overview
Write a 3–4-page proposal for billing changes and explain how the proposed changes will benefit the organization, the physicians, and the patients.
Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Regardless of the corporate structure, health care organizations must remain financially viable. Income must be forecasted according to existing contracts with stakeholders, such as insurers and private payers and state and federal payers.
Health care leaders must also deal with the reality of finite resources, including caring for patients with limited or no resources. The Emergency Medical Treatment and Active Labor Act (EMTALA) requires triage and emergency care for patients in need (Social Security Administration, n.d.). Health care executives are responsible to support emergency care, and they must manage finite resources to achieve this legal imperative.
Social Security Administration. (n.d.). Compilation of the social security laws. Retrieved from http://www.ssa.gov/OP_Home/ssact/title18/1867.htm
Questions to Consider
To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.
Preparation
Use the Capella University Library and the Internet to locate resources and information on health care revenue cycles and billing processes.
Imagine that you have just stepped into a new role as the office manager for a very successful clinic. The clinic is a conglomeration of physicians who offer specialized care. Each group of physicians tried to manage their own billing process, but it quickly became obvious that one billing office would be more efficient. You realize that there has been a lack of consistency in the clinic and that you will need to update the billing policies and procedures immediately. You also realize that there is always resistance to change, and you will need to provide evidence supporting the changes you plan to make.
Prepare a proposal for billing changes that you would present to the physicians. You will need to support each proposed change with relevant evidence to assure buy-in from the physicians.
There is no specific format you must follow for this assessment, but be sure that your proposal is clear, logical, and succinct. Follow APA guidelines for any in-text citations and references. Include a title page and reference page.
Write a proposal for changes you would like to make to the billing policies and procedures in a successful physician’s clinic. Include the following in your proposal: