Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.
Health insurance companies provide the majority of the payment for medical services that clinics and physicians deliver. After the care has been delivered, the medical record is reviewed for completeness, codes are applied, and the billing office submits the claim to the third-party payer or insurance company for payment. Discuss the following:
- What does it mean to submit a clean claim?
- State various reasons for the importance of a clean claim submission.
- Address the consequences of not submitting a clean claim.
- apa FORMAT IN TEXT CITATION 2 REF AND NO PLAGERISM
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- For this Discussion, you will investigate how another organization conducts assessments. Begin by finding out whatever you can through Web searching about your local or state health department’s approach to assessment and strategic planning. Find out also if there are initiatives at the state level to coordinate health assessments from the various communities in the state. If so, are there tools and forms available to do that? (See the Iowa state Web site as an example: http://www.idph.state.ia.us/chnahip/reports_2005.asp.) Then locate and interview someone who has been involved in community health assessment and strategic planning at either a local or state level. To find a person to interview, contact your local health department. Depending on the size of the department, you may wish to ask to interview the director or else ask to be referred to someone who has participated in assessment and strategic planning. If you prefer, you could instead call your state health department; each state should have personnel who deal with coordinating strategic plans from individual counties, and one of these individuals might be a good person to interview. Your interview may be conducted over the phone or via e-mail, or in person if you prefer. (Note: You must transcribe or summarize your interview and post it.) Prepare your thoughts and questions carefully in advance so you can be succinct in your interview. In your interview, you should ask them questions along these lines, as well as any other questions you think are appropriate to the organization or individual you are working with: 1. How do you assess the needs of your community? How often do you conduct assessments? 2. What use did you make of the assessment data? Did you develop a strategic plan or something similar for your department and/or for the community? Please describe this plan. (For example, how detailed is it? Is it a long-range plan?) 3. What are your thoughts about the assessment process? How well is it working? What are specifc strengths of the process from your perspectives? Any barriers or difficulties to overcome? Then: # Identify the organization and title of the person you contacted (for privacy purposes, however, do not identify the name of the person you interviewed). # Summarize the findings of your interview, highlighting what you found most surprising or interesting regarding the challenges and benefits of the community health assessment process. Is there anything you would do differently or do you have suggestions for improvement? # Post a transcript or detailed summary of the interview as an attachment; this will allow other students who are interested to learn more about this organization’s assessment process.