Analyzing and improving claims processing

Topic:

“Analyzing and improving claims processing”

use 5 secondary sources (3 scholarly sources)

Issue/problem to be address:

1.         Background of issue (usually 2-4 paragraphs) (claims processing using paper claims)

2.         Problem statement clearly describing the issue (usually 2-3 paragraphs)

3.         What you hope to accomplish by conducting this (move towards automation –electronic claims)

2. list topics from textbook that will be used

textbook: Krajewski, L., Malhotra, M., & Ritzman, L. (2019). Operations management: processes and supply chains (12th ed.). Upper Saddle River, NJ: Pearson Prentice Hall. (ISBN: 9780134741062)

3. list resources

4. ethical responsibility: maintaining the integrity of the patient record (2 paragraphs)

 
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CMP105: Week 10 Assignment

Case Study: Healthcare Data Standardization

Assignment Overview

This assignment is intended to demonstrate your comprehension of the primary applications of health informatics in healthcare organizations as well as your familiarity with the various informatics applications such as electronic health records (EHR) and telemedicine.

For this assignment, you will read a case study that examines issues concerned with data standardization in informatics. Based on the scenario described in the case study, you will create a presentation related to informatics education and training.

Assignment Details:

Perform the following tasks:

  • Complete the reading assignment and the interactive lesson before attempting this assignment.
  • To complete this assignment:
    • Review the case study.
    • Download the provided PowerPoint template to create a presentation that includes:
      • Your name on the title slide of the presentation
      • Identification of two or more issues with existing system
      • Identification of appropriate “work-a-round” solutions for using existing system
      • Overview of standard language used only in nursing
      • Overview of multidisciplinary standard language
      • Set of five (5) survey questions for staff input on transitioning to new system
      • Presentation is free of spelling and grammar errors.
      • Submit the Week 10 Assignment via Blackboard by clicking on the “Week 10 Assignment” link. Include the proper file naming convention:
        • CMP105_wk10_assn_jsmith_mmddyyyy.

Grading:

Grading Criteria Points Possible Points Earned
Name on title slide of PowerPoint presentation 5  
Identified two or more issues with existing system 25  
Indicates appropriate “work-a-around” solutions when using existing system 30  
Provided overview of standard language used only in nursing from provided list; meets criteria expectations 25  
Provided overview of a multidisciplinary standard language from provided list; meets criteria expectations 25  
Created a set of five (5) open-ended survey questions to elicit staff input 30  
Presentation is free of spelling and grammar errors. 20  
Total Points 160  
  • Case Study

Read the following case study:

A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed.

A major change is being planned. A new chief information officer (CIO) was hired last year and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor and the hospital selected a commercial system.

As a member of the clinical staff with informatics education, the CIO has requested that you develop a training and information presentation for the clinical staff that will:

  • Identify two or more issues with the existing system
  • Provide staff with appropriate “work-around” for using the existing system
  • Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps
    • One standard language should pertain only to nursing
    • One standard language should be multidisciplinary.
  • Obtain clinical staff input, using a five-question survey, of specific methods to support transition to the new system; questions should be open-ended.

PowerPoint Presentation

Directions:

  1. Review the case study.
  2. Download the provided PowerPoint template to create a presentation that includes:
    1. Your name on the title slide of the presentation
    1. Identification of two or more issues with existing system
    1. Identification of “work-a-round” solutions when using existing system
    1. Overview of standard language used only in nursing
    1. Overview of multidisciplinary standard language
    1. Set of five (5) open-ended survey questions for staff input on transitioning to the new system
    1. Presentation is free of spelling and grammar errors.
  3. Submit the Week 10 Assignment via Blackboard by clicking on the “Week 10 Assignment” link. Include the proper file naming convention:
    1. CMP105_wk10_assn_jsmith_mmddyyyy.
 
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Economics

Please answer these questions for my teacher.  Please answer in your own words.

1-What is the difference between contractionary and expansionary monetary policy? What is the intention of each policy under a depression, recession, or robust economy? Which type of monetary policy is more appropriate today and why?

2-What are the uses of money? How do commercial banks and Federal banks create money? Is monetary policy conducted independently in the United States? Explain your answer. Is it important for monetary policy to remain independent from all parties? Why or why not?

 
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Normalisation

Value: 15%

Submission method options: Alternative submission method

Task

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Suppose that you have been given the table structure and data shown in Table below, which was imported from an Excel spreadsheet. 

The data reflect that a professor can have multiple advisees, can serve on multiple committees, and can edit more than one journal.

Table 1: Sample PROFESSOR Records

Attribute Name Sample Value Sample Value Sample Value Sample Value
EMP_NUM 123 104 118  
PROF_RANK Professor Asst. Professor Assoc. Professor Assoc. Professor
EMP_NAME Ghee Rankin Ortega Smith
DEPT_CODE CIS CHEM CIS ENG
DEPT_NAME Computer Info. Systems Chemistry Computer Info. Systems English
PROF_OFFICE KDD-567 BLF-119 KDD-562 PRT-345
ADVISEE 1215, 2312, 3233, 2218, 2098 3102, 2782, 3311,  2008, 2876, 2222, 3745, 1783, 2378 2134, 2789, 3456, 2002, 2046, 2018, 2764 2873, 2765, 2238, 2901, 2308
COMMITTEE_CODE PROMO, TRAF APPL, DEV DEV SPR, TRAF PROMO, SPR DEV
JOURNAL_CODE JMIS, QED, JMGT   JCIS, JMGT  

Given the information in Table 1: 

a. Draw the dependency diagram. (3 marks)

b. Identify the multivalued dependencies. (3 marks)

c. Create the dependency diagrams to yield a set of table structures in 3NF. (6 marks)

e. Draw the Crow’s Foot ERD to reflect the dependency diagrams you drew in Part c. (Note: You might have to create additional attributes to define the proper PKs and FKs. Make sure that all of your attributes conform to the naming conventions.) (3 marks)

NOTE

For guidance on how to normalise database relations from a dependency diagram, watch this very short YouTube video: https://www.youtube.com/watch?v=vkUyuLLgmwQ

Manually drawing the dependency diagram, or the set of 3NF relations or the relational schema is NOT acceptable.

Rationale

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This assessment task will assess the following learning outcome/s:

  • be able to apply normalisation techniques to optimise a database design.
 
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Performance Appraisal

A performance appraisal is a regular review of employee job performance and contribution to organizational objectives. In many cases, performance appraisals are conducted at the end of the year to evaluate employee performance, as well as set performance for the next year. For this assignment, you will evaluate another function of HR and management and its contribution to effective performance management. Prior to beginning work on this assignment, read the article Adapting the Performance Appraisal Process to Meet the Needs of the Modern Workplace (Links to an external site.).

In your paper,

  • Discuss how performance appraisals are a function of HR and management.
  • Analyze the basic components of an effective performance appraisal.
    • Explain how performance appraisals can contribute to organizational goals and objectives.
  • Explain the advantages of performance appraisals and how they contribute to effective training and development.
  • Explain potential forms of discrimination based on labor laws and regulations when conducting a performance appraisal.

For additional support with completing this assignment, please refer to the following tools:

The Performance Appraisal paper

  • Must be two to three double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center’s APA Style (Links to an external site.)
  • Must include a separate title page with the following:
    • Title of paper
    • Student’s name
    • Course name and number
    • Instructor’s name
    • Date submitted

For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.).

Carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your assignment.

 
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"The Most Dangerous Game" 400 word essay

 (1) Choose one of the following short stories to develop your topic:
• Connell, Richard: “The Most Dangerous Game” (pp. 62-79 in Perrine’s Literature)
(2) Use the lists of questions on pages 79 and brainstorming to generate a clear research question and thesis. A good question is such that you look forward to answering it.
(3) Be explicit about what your argument/thesis will be. Each paragraph should support your argument/thesis.
( 4) Use at least one quotation from the story you choose to write about.
(5) Use at least two outside references. List your references in the Works Cited at the end of the essay. Use either MLA or APA (see The Hodges Harbrace Handbook for guidelines).

(6) Make sure your line of argument is clear and coherent; in other words, make a clear point.
(7) The minimum length of essay 1 is 400 words. Use Times New Roman 12 point, double spacing, and one-inch margins. Add word count at the bottom of your last page.

 
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Discussion

Question 1

In Unit 7, we will explore the basic tenets of narrative therapy. The work of Michael White and David Epston discussed metaphors associated with narrative and social constructionism. These ideas revolve around the premise that narrative therapy is more of an attitude regarding reality in a therapeutic context. Some of the ideas posited by this approach to therapy are that realities are socially constructed, realities are constituted through language, realities are organized and maintained through narrative, and there are no essential truths (Freedman & Combs, 1996). Narrative therapy is also concerned with how we perceive the world and how we operate in the world. The issue is that we are born into a world that has a way of viewing, understanding, and accepting all of its basic “truths.” As such, we often find ourselves experiencing our ideas in the context of a dominant social culture. The therapist assists the “patient” in reassessing the “truths” and socially constructed realities in his or her everyday experience. Listening to the “patient’s” story is an important aspect of this therapeutic approach. Helping “patients” understand how their stories can be re-authored to reflect their needs and wants is an important aspect of the narrative approach.

Reference (Hopefully these will help)

Freedman, J., & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York, NY: W. W. Norton & Company.

Theories of Counseling and Psychotherapy: A Case Approach, to read the following:

 Chapter 15, “Narrative Therapy,” pages 478–504.

    González, R. C., Biever, J. L., & Gardner, G. T. (1994). The multicultural perspective in therapy: A social constructionist approach. Psychotherapy: Theory, Research, Practice, Training, 31(3), 515–524.

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    Williams-Reade, J., Freitas, C., & Lawson, L. (2014). Narrative-informed medical family therapy: Using narrative therapy practices in brief medical encounters. Families, Systems, & Health, 32(4), 416–425.

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QUESTION

Narrative Theory Conceptualization

For this discussion, respond to the following:

  • Was the narrative therapy approach a difficult approach to comprehend? Why or why not?
  • Describe a typical narrative that you are familiar with that someone would experience while growing up in a specific region of the United States.
 
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Exhibits

Will present marketing data and value analyze of the marketing exhibits. In addition they will organize the exhibits (label, title, overview, body, notes, and source).

Write a minimum of 2 pages for the exhibits portions for your marketing plan to address the situation in the case study. Which is the women that’s using the services at ECRH. Put the matrix in word format instead of numbers can’t use chart format.

Cite at least 3 reputable references to support your assignment (trade or industry, publications, government, or agency)

Format your assignment according to APA guidelines. 

 
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Economics

I need read and write about what I read in these chapters.

  1. Economics, Ch. 31: Financial Crises, Panics, and Unconventional Monetary Policy

External Content Launch

  • Economics, Ch. 30: Monetary Policy

External Content Launch

  • Economics, Ch 26W: The Multiplier Model

External Content Launch

 
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Topic 2: Leadership Skills and the Behavioral Approach DQ1

Review “Case 3.1: A Strained Research Team,” located in Chapter 3 of the textbook, Leadership: Theory and Practice. Post a 250-300 word response to the questions located at the end of the case. In your response, be sure to address the strengths and weaknesses of the three-skill approach in this situation.

 
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