Discussion of Provider Reimbursement Options in Unit 3 Assignment
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Unit 3 Assignment 1: Reimbursement Options (4009 Reimbursement Options)
Instructions
The following scenario is used to make this assessment:
Patient scenario: Your practice is seeing a new patient for the first time ($500 for a new patient consult).
In your job as a payment specialist for a major primary care practice, describe the various reimbursement methods available to the practice’s providers.
At least three scholarly sources should be used to back up your claims. This may necessitate extra independent investigation on your part. Before you do any additional research, you should examine the Health Care Administration Undergraduate Library Research Guide.
There are two sections to this evaluation.
Part 1: Reimbursement Options for Providers
Present (at least) the four main reimbursement choices that your provider would have for a new patient consult in the scenario. Describe the options and comment on any potential downsides or other factors to consider for each model. Consider the likelihood and difficulties of recouping the entire consult fee for the patient.
Criteria to use as a scoring guide:
Outline the disadvantages of the fee-for-service reimbursement paradigm.
To “describe” someone or something implies presenting a written description of all important attributes, qualities, or events.
Outline the disadvantages of the capitation reimbursement approach in terms of providing complete services.
Explain the impact of pay-for-performance on reimbursement rates.
Explain how a resource-based relative value scale or case-based payment encourages excessive service utilization.
Follow all grammatical, use, and mechanics rules.
The term “grammar” refers to the fundamental rules that govern how sentences are built and how words are combined to form sentences (for example, word order, case, and tense).
Usage refers to proper word choice and phrasing, especially when it comes to word and phrase meanings.
The term “mechanics” relates to the proper application of capitalization, punctuation, and spelling. Format in-text citations and references according to APA guidelines.
Include a separate page for references.
This section could be organized in the following way
Fee-for-service.
What exactly is it?
Consider health-care spending and cost containment; what are the model’s drawbacks?
Capitation.
What exactly is it?
What are the potential disadvantages of this paradigm for doctors who want to give complete care to their patients?
Rewarding good performance.
What exactly is it?
What effect does this model have on reimbursement rates?
Relative value scale depending on resources or case-by-case payment
What exactly is it?
How does this approach encourage excessive use of services?
Part 2: Uninsured Patients’ Payment Options
If the patient in for the new patient consult is uninsured, identify and describe the potential payment methods accessible to the patient and your care provider. Also, be sure to go over how a patient can be eligible for certain payment alternatives, as well as the reasoning behind the associated appointment fee.
Criteria to use as a scoring guide:
Describe the payment choices available to uninsured patients, as well as how the patient would be eligible for each option.
The word “explain” means “to make obvious” (an idea, issue, or problem) to someone by giving more details or providing pertinent facts or concepts.
Follow all grammatical, use, and mechanics rules.
Format in-text citations and references according to APA guidelines.This section could be organized in the following way:
Medicaid.
How does the patient meet the criteria?
Possibilities for financing.
What exactly is this technique?
Self-pay.
How will the patient be compensated? Is it better to take a percentage of commercial contracts or a portion of Medicare payments?
Charitable services.
How would you determine if a patient qualifies for charity care?
How would you go about qualifying a patient for charity care?
Requirement for Additional Submissions
Format: Use the given Reimbursement Options template [DOC]. When submitting your assessment, remember to include a title page and a references page.
Length: 35 pages, plus a title page and a list of references.
References: Include at least three recent scholarly or professional sources in your reference list.
One of the three textbooks can be yours.
Use APA style just for references and citations. Please see:
APA Style Paper [DOCX] Tutoria
In the courtroom navigation panel, there are more APA resources.
12-point Times New Roman font, double-spaced
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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