HIM C807 Western Governors University Health Information Compliance Plan Paper

HIM C807 Western Governors University Health Information Compliance Plan Paper
INTRODUCTIONToday’s healthcare organizations follow regulatory guidelines established by federal, state, and payer program requirements by developing corporate compliance programs. Corporate compliance programs promote a culture in which conduct aligns with ethical behaviors and business integrity. In addition to an enterprise-wide compliance program, a facility may also choose to develop a coding compliance program, which focuses on continuous improvement in the quality of documentation and coding. Health information management professionals may have responsibilities in implementing and participating in these programs.REQUIREMENTSYour submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. A. Analyze a corporate compliance plan by doing the following:1. Describe the seven necessary components of a corporate compliance plan.2. Explain the roles and responsibilities of the staff who implement a compliance plan.3. Explain the roles and objectives of two healthcare enforcement agencies or programs that influence noncompliance reporting.4. Explain the procedure for reporting coding noncompliance. B. Analyze the coding compliance auditing process by doing the following:1. Describe how a healthcare organization should respond to a formal request for an audit by an internal reviewer, and how it relates to coding claims, documentation, or provider claims.2. Describe how a healthcare organization should respond to a formal request for an audit by an external reviewer, and how it relates to coding claims, documentation, or provider claims.3. Explain how a healthcare organization should respond to audit results that show a coding practice resulting in overpayment. C. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.File RestrictionsFile name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )File size limit: 200 MBFile types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7zRUBRICA1. NECESSARY COMPONENTS:NOT EVIDENTThe analysis does not identify any of the 7 necessary components of a corporate compliance plan and does describe each components relevance to the plan.APPROACHING COMPETENCEThe analysis is missing at least 1 identified necessary component of a corporate compliance plan or does not logically describe each component’s relevance to the plan.COMPETENTThe analysis identifies the 7 necessary components of a corporate compliance plan and logically describes each component’s relevance to the plan.A2. RESPONSIBILITIES OF STAFF:NOT EVIDENTThe analysis does not provide an explanation of staff responsibilities.APPROACHING COMPETENCEThe analysis does not provide a logical explanation of the roles and responsibilities of the staff members who implement a corporate compliance plan.COMPETENTThe analysis provides a logical explanation of the roles and responsibilities of the staff members who implement a corporate compliance plan.A3. HEALTHCARE ENFORCEMENT AGENCIES:NOT EVIDENTThe analysis does not explain the roles and objectives of 2 healthcare enforcement agencies or programs and does not explain how they influence corporate compliance programs.APPROACHING COMPETENCEThe analysis does not provide an appropriate explanation of the roles and objectives of 2 healthcare enforcement agencies or programs or does not explain how the agencies or programs influence corporate compliance programs.COMPETENTThe analysis provides an appropriate explanation of the roles and objectives of 2 healthcare enforcement agencies or programs and how they influence corporate compliance programs.A4. NONCOMPLIANCE REPORTING PROCEDURE:NOT EVIDENTThe analysis does not include a description for accurately reporting coding non-compliance.APPROACHING COMPETENCEThe analysis does not accurately describe the procedure an HIM professional should follow for reporting coding noncompliance.COMPETENTThe analysis accurately describes the procedure an HIM professional should follow for reporting coding noncompliance.B1. INTERNAL AUDIT:NOT EVIDENTThe analysis does not describe the process that an organization should use to respond to a formal request for an internal audit.APPROACHING COMPETENCEThe analysis does not logically describe the process that an organization should use to respond to a formal audit request by an internal reviewer or does not explain the connection of the internal audit to coding claims, documentation, or provider claims.COMPETENTThe analysis logically describes the process that an organization should use to respond to a formal audit request by an internal reviewer and explains the connection of the internal audit to coding claims, documentation, or provider claims.B2. EXTERNAL AUDIT:NOT EVIDENTThe analysis does not describe the process that an organization should use to respond to a formal request for an external audit.APPROACHING COMPETENCEThe analysis does not logically describe the process that an organization should use to respond to a formal audit request by an external reviewer or does not explain the connection of the external audit to coding claims, documentation, or provider claims.COMPETENTThe analysis logically describes the process that an organization should use to respond to a formal audit request by an external reviewer and explains the connection of the external audit to coding claims, documentation, or provider claims.B3. RESPONSE TO OVERPAYMENT:NOT EVIDENTThe analysis does not explain how an organization should respond to audit results that show a coding practice that resulted in overpayment.APPROACHING COMPETENCEThe analysis provides an illogical explanation of how an organization should respond to audit results that show a coding practice that resulted in overpayment.COMPETENTThe analysis provides a logical explanation of how an organization should respond to audit results that show a coding practice that resulted in overpayment.C. APA SOURCES:NOT EVIDENTThe submission does not include in-text citations and references according to APA style for content that is quoted, paraphrased, or summarized.APPROACHING COMPETENCEThe submission includes in-text citations and references for content that is quoted, paraphrased, or summarized but does not demonstrate a consistent application of APA style.COMPETENTThe submission includes in-text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style.PROFESSIONAL COMMUNICATION:NOT EVIDENTContent is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.APPROACHING COMPETENCEContent is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.COMPETENTContent reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.

QUALITY: 100% ORIGINAL – NO PLAGIARISM

(USA, AUS, UK & CA PhD. Writers)

CLICK HERE TO GET A PROFESSIONAL WRITER TO WORK ON THIS PAPER AND OTHER SIMILAR PAPERS

The Best Custom Essay Writing Service

About Our Service

We are an online academic writing company that connects talented freelance writers with students in need of their services. Unlike other writing companies, our team is made up of native English speakers from countries such as the USA, UK, Canada, Australia, Ireland, and New Zealand.

Qualified Writers

Our Guarantees:

CLICK TO SUBMIT YOUR ORDER