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What is the impact of the Anti-Kickback Statute on healthcare reimbursement and referrals
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- What are the provisions of the False Claims Act in healthcare reimbursements?The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from making referrals to an entity for certain healthcare services, if the physician has a financial relationship with the entity. How can a physician get around the Physician Self-Referral Law?How is the Anti-Kickback Statute different from the Physician Self-Referral Law?
- What is the difference in the reimbursement cycle among long-term care facilities as compared to most other healthcare facilities?Why do insurance companies practice things like restricting provider choice, gatekeeping, and pre-authorization?The difference between a remittance advice (RA) and an explanation of benefits (EOB) is: The RA goes to the provider only and includes payment information. The EOB goes to the provider. The RA is sent to the patient and includes payment information. The EOB contains payment information.
- How is compliance to regulatory requirements in healthcare reimbursement built into the back-end processesExplain how the ACA could impact an organization’s strategic decision making and financial performance regarding healthcare reimbursement.Discuss the financial impact of initially declined claims and delayed payments to healthcare organizations
- The Inpatient Payment System is used by Medicare to pay hospitals for services at a pre-determined rate for each discharge. Professional Administrative C) Prospective DiagnosticDo you think NANDA-I, NOC & NIC are applicable to Nursing Documentation (conventional written or electronic) here in the Philippine Setting? Why or why not? If it needs improvements or changes to be more effective and applicable to Nursing Documentation, what would it be?What are the weaknesses that may occur from the inpatient service system when carrying out standard procedures given to patients?
