Posted: February 27th, 2022

Assessment of clinical data required for payment and reimbursement systems (PPS, DRG

You will start working on this assignment in Lesson 2. Each week, you will work on this assignment, in addition to any other assignments for that week. This assignment will be due in Lesson 7.

Assignment Instructions

Prepare a revenue cycle plan for a community hospital. Include the following information in your plan:

Introduction
Assessment of clinical data required for payment and reimbursement systems (PPS, DRG, RBRVS, RUGs, VBP, Billing/insurance plans).
Explanation of chargemaster and claims management applications and processes.
Assess effect on healthcare finance of revenue management (cost reporting, budget variances).
Summarize revenue cycle management and reporting processes (CCI, X12N).
Assessment of severity of illness and how it impacts the healthcare payment systems.
The format of this plan is like a policy and procedure but is a longer document. Compile your document based on the findings and collection of information for each of the requirements.

RECOMMENDED TEXT(S):
Mosby, I. (2009). Mosby’s Dictionary of Medicine, Nursing & Health Professions (8th ed.). St. Louis, Mo.: Mosby/Elsevier.
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This project will be the first thing you work on in Lesson 2. Work on this task each week, in addition to any other assignments you have for that week, will be your primary focus. In Lesson 7, you will be responsible for completing this task.

Instructions for the assignment

Preparing a revenue cycle plan for a community hospital will be your assignment. You should incorporate the following facts into your plan:

Introduction
Obtaining and evaluating clinical data necessary for payment and reimbursement systems (PPS, DRGs, RBRVS, RUGs, VBP, billing/insurance plans).
The chargemaster and claims management apps and processes are explained in detail.
Revenue management’s impact on healthcare financing should be evaluated (cost reporting, budget variances).
Processes for revenue cycle management and reporting should be summarized (CCI, X12N).
Assessment of the severity of the sickness and how it affects the healthcare delivery and reimbursement systems.
It follows the same format as a policy and procedure, however it is a longer document in total length. Compile your document based on your conclusions and the information you have gathered for each of the standards listed above.

TEXT(S) RECOMMENDED: Mosby, I., et al (2009). Mosby’s Dictionary of Medicine, Nursing, and Health Professions is a reference book for medical professionals (8th ed.). Mosby/Elsevier, St. Louis, Missouri.

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