Week 3 Milestone 2 Guidelines
HCM 345 Milestone Two Guidelines and Rubric Overview: Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system. An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge. Milestone Two provides you an opportunity to engage with real-world data that you would encounter in an actual professional environment. Specifically, you will take a closer look at how reimbursement impacts other healthcare departments, and you will dive deep into utilizing data, tracking records, and ensuring compliance within individual departments. Prompt: Submit a draft of Section II of the final project. Specifically, the following critical elements must be addressed:
II. Departmental Impact on Reimbursement A. Describe the impact of the departments at this healthcare organization that utilize reimbursement data. What type of audit would be necessary
to determine whether the reimbursement impact is reached fully by these departments? How could the impact of these departments on pay-for- performance incentives be measured?
B. Assess the activities within each department at this healthcare organization for how they may impact reimbursement. C. Identify the responsible department for ensuring compliance with billing and coding policies. How does this affect the department’s impact on
reimbursement at this healthcare organization? Guidelines for Submission: Your paper must be submitted as a three- to four-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and at least three sources, which should be cited in APA format.
Rubric Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Departmental Impact on
Reimbursement: Departments
Comprehensively describes the impact of the departments that utilize reimbursement data at this healthcare organization that also influence reimbursement
Describes the impact of the departments that influence reimbursement, but description is not comprehensive or is not specific to this healthcare organization or to departments that utilize reimbursement data
Does not describe the impact of the departments at a healthcare organization that influence reimbursement
30
Departmental Impact on
Reimbursement: Activities
Assesses the activities within each department at this healthcare organization for how they may impact reimbursement
Assesses the activities within each department at this healthcare organization but does not explicitly link these activities to reimbursement, or assessment is not specific
Does not assess the activities within each department at a healthcare organization for how they may impact reimbursement
30
Departmental Impact on
Reimbursement: Responsible Department
Correctly identifies the department responsible for ensuring compliance of billing and coding policies and its impact on reimbursement at this healthcare organization
Identifies the department responsible for ensuring compliance of billing and coding policies and its impact on reimbursement at this healthcare organization, but identification is incorrect
Does not identify the department responsible for ensuring compliance of billing and coding policies
30
Articulation of Response
Submission has no major errors related to citations, grammar, spelling, syntax, or organization
Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas
Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas
10
Earned Total 100%