N Assignment Example | Topics and Well Written Essays - 500 words - 1

N - Assignment Example Just as it applies to other corporate firms, planning strategically is adopted by hospitals following the same pattern that initiates with formulation, proceeds with execution, then evaluation of outcomes thereafter. Based on a more formal convention, carrying out a strategic plan essentially consists of four stages: -- (1) strategic formulation; (2) strategy implementation; (3) strategy monitoring; and (4) a disciplined analysis – all of which are linked from one stage on to the next in a loop, implying that the implemented strategy does not necessarily have to occur merely once with the same founded setting. The stages in cycle depict the flexibility at implementing schematic flow of agreements such that upon reaching the final stage and the strategies are assessed to have fallen short of meeting the targeted ends or set requirements and objectives, the responsible medical administrative body goes to find alternative means by which to remedy and modify with a new set of plans to work on. On accomplishing a strategy, the medical institution may need to prepare in coping with internal changes concerning the set objectives, action plans and budgets generated, level of accountability, duties and culture, as well as timelines. The course of implementation varies with complexity especially as it becomes spontaneously affected by factors that come in barrier form as – management barrier, vision barrier, people barrier, and resource barrier. Market assessment outline eventually requires thorough analytics as observed or studied from the strategic planning executed. A research on a well-implemented strategic plan indicates tight connection between long-term strategy and measures to more tactical planning and budgetting. Because each health organization has its own set of culture, mission, and vision to live by as seen fit by its constituents, a strategic plan is designed not only to settle

Job Application Questions Essay Example | Topics and Well Written Essays - 2250 words

Job Application Questions - Essay Example I respond to daily inquires by telephone and in written correspondence. Most of this communication explains why a claim was denied. To appropriately identify whether a claim was denied in error I reference CPD/CSC desk procedures to research each denial. For instance, if a claim was denied for a code196, surgery not authorized in ASC, I reference the CPD/CSC desk procedures to research whether the code is found in Tricare’s ASC list and in Medicare’s list. I then use the X-code job aide to verify the correct code was used to process the claim. The CHAMPVA policies and regulations are designed to outline the Code of Federal Regulations (CFR). Medicare, Tricare, and CHAMPVA follow rules and regulations listed in the CFR. CHAMPVA follows Tricare’s policy, guidelines, and allowable rates. As a CSR it is important for me to cite various federal codes to providers, sponsors, and beneficiaries. This is especially true when it comes to timely filing, allowable rates, and cost sharing given that these are the areas that are most often appealed. For instance, the Code of Federal Regulations (38 CFR 17.275) outlines a claim filing deadline. With CHAMPVA it is one year from date of service (DOS) for outpatient services but for inpatient services it is one year from discharge date. In the case of retroactive approval, it is 180 days following beneficiary notification of authorization. In the 38 CFR 17.276 outline the appeal and review process for CHAMPVA for claim denials, providers and beneficiaries have one year from denial date to submit an appeal, and 90 days to submit a second level appeal after the initial appeal denial. I use EncoderPro for Internet sufficient research to evaluate sources and appropriately analyze information. To properly answer calls on whether a benefit is covered, using EncoderPro helps me navigate the CHAMPVA policy manual to find the