Special Topics In Healthcare Financial Management

Assignment Details

Research Paper

Non Plagiarized Grammatical Error Free document

Search course materials, including your text and the Internet, to find a spreadsheet program that will assist you in completing this assignment. The spreadsheet and calculations are to be attached at the end of the paper as an appendix after the Reference page.

Case Study: You are assessing the payer–patient mix for a health care organization(The University of Texas Southwestern Medical Center). Currently, your payer mix is 40% Medicare, 10% Medicaid, 25% traditional indemnity insurance, 20% managed care, and 5% self-pay patients. Complete the following:

  • Using      the most common office visit, CPT code 99214, determine the reimbursement      from the Centers for Medicare and Medicaid Services (online fee schedule      available for Medicare).
  • Using      the same CPT code, 99214, determine the reimbursement for Medicaid (fee schedules      should be available from the individual state).
  • Using      the same CPT code, 99214, create at least 3 other traditional indemnity      insurance reimbursements. If possible, use the actual reimbursement from      the insurance carrier. It may be possible to obtain actual reimbursement      information from your personal insurance carrier. If the information is      not available, assume reimbursement by traditional indemnity insurance is      usually 200% reimbursed more than Medicare and Medicaid, and managed care      is usually 133% more than Medicare and Medicaid.
  • Compose      an accounts receivable benchmark from this information showing columns for      current, 30–60, 61–90, 90–120, and greater than 120 days.
  • Assess      the information for areas of improved reimbursement of at least 20% or      more.
  • Evaluate      the options available to change the payer–patient mix with consideration      of related legal and ethical issues.
  • Propose      a best strategy with justification and rationale based on effective      decision-making tenets.

The body of the resultant paper should be 10–12 pages. Spreadsheets demonstrating the accounts receivable analysis will be attached as appendices, and there will be at least

7 relevant peer-reviewed academic or professional references published within the past 5 years.

Also attach appropriate fee schedules

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