Comprehensive Health Insurance PT 2

12.   Ralph is assigning diagnosis and procedure codes for a 35-year-old patient from New Mexico, who has hypertension and end-stage renal disease. Would this patient qualify for Medicare?

13.   The first prepaid health insurance plans in the United States were   14.   Which of the following is the largest privately underwritten health insurance contract in the world?       15.   A provider is classified as a/an     16.   Tom is billing an emergency room visit for a Medicaid patient who’s being seen for a wellness visit. Which one of the following statements is true as a result of the Balanced Budget Act?   17.   Dr. Singer is working within a reimbursement system in which the insurance is billed after all the treatment has been given to the patients. What is the main reason that the doctor orders more tests, exams, and procedures under this system? 18.   With a PPO, the beneficiary has the ability to 19.   Physician-hospital organizations (PHOs) are also called _______ organizations.   20.   Mrs. Fang is a 72-year-old retired school teacher who has been hospitalized for pneumonia. What type of insurance is most likely being used to pay for her hospital stay?

Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.

For this Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.

To prepare:

· Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.

· Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.

· Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

· Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.

· Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.

To complete:

Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

· Identify a problem, inefficiency, or issue within a specific department/unit.

· Describe a specific, realistic change that could be made to address the issue.

· Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

· Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.

· Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.