Unit IV Case Study

Analyze the case study found on p. 343 in the textbook by addressing the assigned questions below. While analyzing the case, be sure to identify the major problems and issues.

Draft a response or strategy for addressing the major problems and issues.

Make recommendations to improve the patient’s health.

Discuss any negative consequences that may occur if the patient’s health issue is not addressed.

Your response should be at least one page in length. Include at least one reference to support your work in APA style. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

Explain why taking aspirin as soon as symptoms of a possible heart attack begin may help the patient.

Your response must be at least 200 words in length.

What is atherosclerosis? Explain the surgical options for treatment of atherosclerosis.

Your response must be at least 200 words in length.

 

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Instructions

For the Unit VIII PowerPoint Presentation, you will assume the role of a candidate interviewing for the director of medical billing at Columbia Southern Medical Group. The interview panel has provided you with five questions, and they would like you to create presentation slides with your response(s). Below are the five interview questions.

1. Columbia Southern Medical Group is an organization that prides itself on being on the forefront of innovation. By fulfilling this role as the director of medical billing, you would be expected to maintain knowledge on health insurance developments and new strategies in the field. What three recent developments in health care have influenced the climate of reimbursement the most, in your opinion? Be sure to detail each development. (two slides)
2. Some of your tasks as director of medical billing will lead you to be involved in Columbia Southern Medical Group’s medical coding procedures. Seeing that Columbia Southern Medical Group provides both inpatient and outpatient services, explain the types of medical coding that will be used in your department. Explain the relationship between the coding and billing departments, and identify some of the issues that could arise with incorrect coding/billing. (two slides)
3. Columbia Southern Medical Group does accept Medicare assignment in most cases, but there are two facilities owned by Columbia Southern Medical Group that do not participate with the Medicare program. With what you know about the Medicare Physician Fee Schedule (MPFS) and how it differs regarding participating providers versus non-participating providers, outline the differences in how these separate entities would conduct payments with this system. It may be a good idea to provide an example with the two different calculations describing how a service or procedure would be reimbursed under these scenarios. (two slides)
4. Being in compliance with healthcare regulations is of the utmost importance to Columbia Southern Medical Group, and it is imperative that all of its departments operate ethically and with integrity. One of your tasks as director will be to implement policies that will provide protection and security of all sensitive data housed in your department. Name safeguarding techniques that you will use to ensure privacy and security of patient information. Furthermore, describe regulatory standards and/or healthcare laws that will explain and enforce compliance measures. How do these measures help combat fraud and abuse? (two slides)
5. Columbia Southern Medical Group has always worked hard to create an atmosphere of continuous improvement as that has shown to lead to a more quality experience for the patient. By keeping up with current trends in the industry as well as ensuring that all regulatory and legal requirements are met, Columbia Southern Medical Group will continue to provide quality unmatched by others. One regulatory requirement that you will be tasked with as the director of medical billing is auditing. What are some healthcare third-party audits specific to medical billing and coding of which you will need to be knowledgeable? What are your thoughts on random self-audits? Do you think they can be helpful to you and your department if you were to obtain this position? (two slides)

Your presentation should consist of a total of 10 slides, not counting the title and reference slides.

 

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 QUESTION 1.

Diphtheria is a symptom.

True

False

QUESTION 2.

 Jaundice is a sign or symptom.

True

False

QUESTION 3.

 Coughing is a diagnosis.

True

False

QUESTION 4.

 Night sweats is a diagnosis.

True

False

QUESTION 5.

 Knowing how to locate neoplasm while coding can be very difficult for many. Give a step-by-step guide of how to locate neoplasm.

Your response should be at least 75 words in length.

QUESTION 6.

 Knowing the difference between signs/symptoms and a diagnosis can be difficult. A new student joined the class late and needs to know how to tell the difference between the two. Give an explanation that would help the student understand the difference.

Your response should be at least 75 words in length. 

 

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 QUESTION 1 Matching

Body mass index (BMI)

MUST

Anthropometry

Micronutrients

Lipid

 

Protein

Obesity

Macronutrients

 

Glucose

 

Hypertension 

 

a.A term generally used for fats and oils.

b.Comes from breaking down carbohydrates and is used to produce energy.

c.A complication that may be caused by obesity.

d.Daily intake is vital for bodily function.

e.Tool used to identify excess adipose tissue.

f.Organic compounds required in small amounts for normal body functions; such as vitamins and minerals.

g.Excessive accumulation of fact cells for an individual’s height and weight.

h.Tool that measures skinfold thickness.

i.Malnutrition universal screening tool used to determine the nutritional status of a patient.

j.Organic compounds required in large amounts for normal body functions; such as carbohydrates and proteins

QUESTION 2

 

1. Discuss the process of digestion by explaining the following:

• Where does it begin?

• What are the roles and functions of saliva, the stomach, and the accessory organs?

Your response should be at least 500 words in length.

 

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