Quality and Risk Management in Healthcare Colorado College GB and PS discussions

Please complete all parts

Part 1

Choose one of the primary source documents from the topic list below. Using the primary source reading, answer the following questions. Use this template provided to complete the assignment.

1. Context (20 points):
   1. Name of the document you chose to analyze
   2. Who is the creator of the document?
   3. Briefly describe the creator of the document. (To answer this question, you may need to use information obtained from the introduction to the source, or other course materials such as the textbook or Intellipath.
   4. When and where was the document created? (Again, you may need to use information obtained from the introduction to the source, or other course materials such as the Lib Guide, Intellipath, or your instructor.)
2. Summary (20 points):
   1. Write a brief summary of the source. (What is the topic or issue of the source? What are the creator’s main points about that topic? What is one interesting thing said in this source?)
3. Connections (20 points):
   1. How does this source help you to better understand a topic you learned about in the Unit learning materials? (Here you want to think about how this source fits into the other material for the unit such as the Lib Guide and Intellipath.)
   2. Does this source support what you already know about the topic? If so, how? Or does this source change the way you think about this topic? If so, how?

Choose one of the following documents to complete this assignment

• Richard N. Goodwin, “Memorandum For the President,” November 1, 1961
• John F. Kennedy, “Cuban Missile Crisis Speech,” October 22, 1962
• John Kerry, “Statement of Vietnam Veterans Against the War,” April 23, 1971
• National Organization of Women, “Statement of Purpose,” 1966
• Cesar Chavez, “Talks in New York,” June, 1968
• SNCC Vine City Project, “Black Power,” 1966

Part 2

Choose one of the primary source documents from the topic list below. Using the primary source reading, answer the following questions. Use this template provided to complete the assignment.

1. Context (25 points):
   1. Name of the document you chose to analyze
   2. Who is the creator of the document?
   3. Briefly describe the creator of the document. (To answer this question, you may need to use information obtained from the introduction to the source, or other course materials such as Intellipath or your Instructor.)
   4. When and where was the document created? (Again, you may need to use information obtained from the introduction to the source, or other course materials such as Intellipath or your Instructor.)
2. Summary (30 points):
   1. Write a brief summary of the source. (What is the topic or issue of the source? What are the creator’s main points about that topic? What is one interesting thing said in this source?)
3. Connections (30 points):
   1. How does this source connect to the Unit 4 Learning Material? How does it help you better understand that moment in American History? (Here you want to think about how this source fits into the other material for the unit in the Lib Guide, Intellipath, or your Instructor.)
      Does this source support what you already know about the topic? If so, how? Or does this source change the way you think about this topic? If so, how?
4. Issue Today (25 points)
   1. Identify how the issue in the document relates to American life today. You will want to use specific examples to explain your points.

• Buchanan, P. J. (1992). Address to the Republican National Convention. Retrieved from
• Bush, G. H. (1990). Iraqi Aggression in Kuwait. Speech before the United Nations General Assembly. (See PDF)
• Reagan, R. (1981). Remarks on signing the Economic Recovery Tax Act of 1981 and the Omnibus Budget Reconciliation Act of 1981, and a question and answer session with reporters. Retrieved from
• Reagan, R. (1987). Tear down this wall. Retrieved from
• All sources used to complete this project should be cited using APA format, both in-text citations and references. Please use the CTU Undergraduate Writing Style Guide for assistance on APA formatting.

  References will vary based on topic.

Part 3

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

You are a new graduate, and you just started work at a medium-sized hospital with an attached clinic. You have been asked to review the five different types of health care insurance plans and the characteristics of each to make sure the central business office (CBO) is up-to-date on all the rules and regulations. It is important to be familiar with these plans and the characteristics of each because they play a vital role in the reimbursement process for your health care organization. Discuss the following:

• List the five different types of health care plans and 2–3 characteristics of each.
• Explain why it is important to understand the differences in these plans.
• What are some of the similarities between the plans?
• What are some of the differences?
• Would an out-of-date policy from one of these plans affect the facilities reimbursement? If so, how?

Part 4

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Accurate coding and billing are essential to a health care facility and to a physician’s financial survival. Coding is a complex task that ties to charges and revenue generation. Failure to capture all charges associated with a patient encounter can result in significant revenue loss. Medical necessity also plays a vital role in the contract with the facility or physician in terms of receiving payment from the third party payer (e.g., an insurance company).

Part 1

For this Discussion Board, you will define medical necessity, and you will describe the criteria to determine it.

Part 2

Once the patient has an established diagnosis and the services and procedures have been ordered, you will code out this information and place it on the claim for payment.

It is important for health care professionals to understand this process to receive accurate reimbursement.

For this part of the discussion, you will be identifying the coding systems that are utilized to support the diagnosis, services, and procedures.

List and discuss the coding system that is utilized to code out the patient’s conditions or diagnosis. Provide an example of a diagnosis with the appropriate code as an example, and respond to the following questions:

• What is the coding system replacing the diagnostic system?
• Will it be implemented this year? Explain your answer.

Next, identify what coding system is utilized to capture the services and procedures that the patient has received (both levels). List an example of a service or procedure with the appropriate code as an example, and respond to the following questions:

• Why is it important to assign the correct codes to the diagnoses, services, and procedures that a patient has received?
• What are the repercussions of submitting incorrect coding and billing errors to the third party payers?

Part 5

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

There have been some major developments in the health care industry with the evolution of managed care, patient-centered care, electronic medical records, medical necessity, stronger rules and regulations, and government intervention. You are fairly new at your job, so you have been asked to identify and review the federal regulations that impact (or have impacted) the financial management of the hospital and clinic.

Complete the following for this Discussion Board assignment:

• Choose 3 of the major developments in health care history to discuss.
• List the year and the event, and then summarize how you think this event has impacted the health care industry today.

Note: You must provide citations from your research.

Part 6

A

There are many reimbursement methods that are utilized to reimburse physicians and facilities for the services and procedures that they provide to patients. A physician and the facility must keep track of the services and procedures that they are providing to the patients to bill out and receive the appropriate reimbursement. The chargemaster or charge description master (CDM) is the billing process that is used in all health care facilities, and it is updated yearly.

Focus your discussion on the following questions:

• What are the consequences of not utilizing current codes and charges? Discuss how using last year’s CDM will affect the current year’s bottom line.
• Will this create a positive or negative result for the health care facility? Explain your answer.
• How can facilities ensure that the current CDM is used?

B

Summative Discussion Board

Review and reflect on the knowledge you have gained from this course. Based on your review and reflection, write at least 3 paragraphs on the following:

• What were the most compelling topics learned in this course?
• How did participating in discussions help your understanding of the subject matter? Is anything still unclear that could be clarified?
• What approaches could have yielded additional valuable information?
• The main post should include at least 1 reference to research sources, and all sources should be cited using APA format.