Instructions:
Concept to Consider:
Imagine you are the health information management director at your local hospital. It has just been announced that the hospital is going to evaluate the government-sponsored healthcare programs.
You have been asked to prepare a presentation to the hospital administration to help educate the healthcare providers about the reimbursement rates. In preparation for the development of your presentation, review the information in your text, supplemental reading including the
\u201ctoolkit,\u201d and available websites for the most up-to-date information.
Part 1:
Prepare a Medicare Part A\u2013D and Voluntary Choice grid. Your grid should be detailed and include the following: cost, deductibles, copayments, examples of covered services, and any other details you think are important.
It is also important that you make sure the grid is easy to understand. In addition, provide at least three websites or other services that the administration may want to use to help them to better understand the facts.
Name of insurance (topic)
Coverage
Premium
Deductible
Copayment
Enrollment provisions
Special circumstance
Narrative explanation to accompany the grid:
Provide a narrative to accompany your table explaining the medical coverage for the topics (Medicare Part A, Medicare Part B, Medicare Advantage, Medicare Part D, and Voluntary Insurance Plan). Create 1\u20132 paragraphs for each topic addressing the listed issues.
An example table is illustrated below. Your table may be developed in Excel or Word.
Sample Grid
Topic
Medicare Part A
Medicare Part B
Medicare Advantage
Medicare Part D
Voluntary Insurance Plan
Coverage
Premium
Deductible
Copayment
Enrollment Provisions
Special
Circumstance
Part 2:
Answer the following questions by performing a search:
National coverage determinations (NCDs) and local coverage determinations (LCDs) define the specific diagnosis and procedure codes that support medical necessity for many services provided.
Conduct a browser search for obtaining medical coverage determination information.
Enter \u201cnational coverage determinations\u201d in the browser.
Note: Examine the NCD related to bariatric surgery for treatment of morbid obesity.
Questions
Create 1\u20132 paragraphs for each question:
Identify five procedures described in the bariatric surgery NCD.
Name three criteria a patient must meet to be eligible for Medicare payment for the surgery.
Identify the bariatric procedures not covered by Medicare.
Explain the relationship between DRGs and approved procedure \u2014 medical documentation.
Your presentation should:
Create a bibliography citing a minimum of three references according to APA format.
Resources can include your text and chapter references, organizational websites, or such resources as the American Medical Association, American Hospital Association, or the American Health Information Management Association.
The paper should include the following: Part 1: The grid, five narrative explanations (1\u20132 paragraphs for each service)
Part 2: NCD search (including title or reference pages) <\/p>\n
The paper should follow the conventions of Standard American English (correct grammar, punctuation, etc.).
Your writing should be well ordered, logical, and unified, as well as original and insightful. Your work should display superior content, organization, style, and mechanics.
You should cite sources using APA format.
Presentation must be professionally attractive. <\/p>\n","protected":false},"excerpt":{"rendered":"
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