Define compliance and reimbursement and discuss their financial relevance in healthcare organizations. What accounting methods are applicable and why?

Health insurance and reimbursement methodologies are some of the basic foundations of understanding health care finance. Health care administrators must have a basic understanding of these areas to successfully run their respective departments and/or organizations. Interestingly enough, most consumers have no concept of how their benefits are designed, implemented, and paid for. Understanding health insurance from a financial perspective is one aspect to review. Aligning the insurance with networks, co-pays, co-insurance, and deductibles from a structural perspective and connecting the dots with providers and payors complicates matters even further. Hopefully, this section will clarify these complexities.

Three to five pages, APA formatted ,describing the critical areas of reimbursement and how they function? Journal and/or peer reviewed articles required. Industry terminology must be used. Current research, within the last five years preferred.

Case Study 1 & 2 (10 Points)

Students must review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

The answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use past students’ work as all files submitted in this course are registered and saved in turn it in the program.

Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. No Straight forward / Simple answer will be accepted. 

Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

All answers to case studies must have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study

Case Study 1

Mr. JS presents today to your office for a follow up appointment after a BP reading at home of

166/95 last week. He is a 52 y/o male with a PMH of HTN and Angina secondary to CAD, which

is well controlled, experiencing less than 1 attack per month.

On today examination, MR JS’s vital signs are as follows:

Temperature: 96.8º

Heart Rate: 68 bpm

Blood Pressure: 168/92

Respiration: 14

Ox Sat: 95% at room air

Pain: denies pain.

Labs:

Last LDL on records (6 months ago): 189

Current Medications:

Atorvastatin 40 mg/day

Metoprolol tartrate 10 mg/twice/day

CASE STUDY QUESTIONS:

1) According to the recently released American Heart Association guidelines on hypertension,

what should be the BP goal for a patient with chronic stable angina and hypertension?

2) In addition to diet and lifestyle modifications, what is the medication of choice to control the

BP of a patient with chronic stable angina? Provide rationale

3) Provide at least 3 (questions) you would ask your patient RELATED to the case presented and

provide rationale.

4) Please explain whether you would request any laboratory or screening tests for this patient

and why (if any)

5) How would you achieve the B/P goal recommended for this patient according to the

guidelines provided above?

6) Provide References in APA style

……………………………………………………………………………………………………………………………………………………..

Case Study 2

Testicular Cancer

Case Studies

A 21-year-old male noted pain in his right testicle while studying hard for his midterm college

examinations. On self-examination, he noted a “grape sized” mass in the right testicle. This

finding was corroborated by his healthcare provider. This young man had a history of delayed

descent of his right testicle until the age of 1 year old.

Studies Results

Routine laboratory studies Within normal limits (WNL)

Ultrasound the testicle Solid mass, right testicle associated with calcifications

HCG (human chorionic gonadotropin) 550mIU/mL (normal: <5)

CT scan of the abdomen Enlarged retroperitoneal lymph nodes

CT scan of the chest Multiple pulmonary nodules

Diagnostic Analysis

At semester break, this young man underwent right orchiectomy. Pathology was compatible with

embryonal cell carcinoma. CT directed biopsy of the most prominent pulmonary nodule

indicated embryonal cell carcinoma, compatible with metastatic testicular carcinoma. During a

leave of absence from college, and after banking his sperm, this young man underwent

aggressive chemotherapy. Repeat testing 12 weeks after chemotherapy showed complete

resolution of the pulmonary nodules and enlarged retroperitoneal lymph nodes.

Critical Thinking Questions

1. What impact did an undescended testicle have on this young man’s risk for developing

testicular cancer?

2. What might be the side effects of cytotoxic chemotherapy?

3. What was the purpose of preserving his sperm before chemotherapy?

4. Is this young man’s age typical for the development of testicular carcinoma?

For this assignment you will begin to create a concept map (final concept map assignment is due in week 9).

1.       Identify an individual in your personal life, from the media, a character in a movie, or from the course case studies that has been diagnosed with a medical condition you have some knowledge about (examples = diabetes, breast cancer, COPD)

2.       Summarize the individual/character and his/her medical diagnosis on the template provided.

3.  Provide examples of the subjective and objective symptoms related to the medical diagnosis under each corresponding Gordon’s Functional Pattern using the TEMPLATE provided (see handouts in learning resource folder for assistance).

 The following post is from another student to which i have to reply adding some extra info

APA 

less than 10 % similarity

Essential oils are basically plant extracts. They’re steamed or maybe by pressing different areas of a vegetable (flowers, bark, leaves or even fruit) to record the ingredients which make the fragrance. It is able to capture many fat from a vegetable to create one container of essential oil. Along with building fragrance, essential oils additionally do some other features in vegetation. Based on the mechanical, “Chemicals present in oils that are essential are absorbed by the entire body, leading to psychological or physiological benefits. Aromatherapy is the healing use of plant essential oils to cure the entire body, mind and mind. This’s a training course of herbal medicine, and the basis of its of activity is equivalent to that of contemporary pharmacology” (Fontaine, 2019, p.134).

Essential oils may be applied topically on the skin. Common examples consist of placing a blend which containsblack pepper (Piper nigrum)or ginger(Zinziber officinalis)essential used oil to minimize osteoarthritis pain and also boost flexibility, and use crucial camomilleallemande oil(Matricaria recutita) totreateczema (Siroli, et all, 2020). The skin of ours is a bit of permeable. Chemicals lively in oils that are essential are absorbed in addition to ingredients in typical drugs including hormone replacement lotion as well as nicotine patches. Distinct elements are able to influence the absorption of important oils with the skin. If perhaps you rub the spot first, it is going to increase blood circulation to this particular spot, leading to a rise in the absorption of important oils (Siroli, et all, 2020). The high temperature will even boost circulation and therefore boost absorption. Several scientists claim that essential oils could be more quickly taken in by skin websites with increased levels of sweat glands as well as hair roots, like the genitals, plant, head, armpits and palms.

Once you incultivat an important oil by holding the bottle in the nose or perhaps by way of a diffuser, the place attributes achieve the olfactory method in the roof of the nose. The small nerves in the nose of yours have immediate access to the brain of yours. When activated, they deliver a message straight to the limbic system of yours in the human brain suggesting to begin acting promptly (Siroli, et all, 2020). The limbic system of ours will be the middle of command of emotions, memory, mind and mood. Exactly what the brain sparks the body is dependent on the essential oil we instill. For instance, in case we alarm the essential oil of lavender, the nervous system of ours is going to begin to loosen up, providing (among some other things), leisure as well as looking well being. The engine oil induces the release of serotonin in to the entire body, that decreases anxiety, encourages improved sleep and also eliminates a headache or even migraine.

The alternative way to make use of essential oils would be to place them on the skin. Whenever we try this, the healing qualities in the oils are absorbed by our pores and hair roots and go into the blood stream. When on each, the feast starts and they’re spread in the organs as well as systems which heal along with soothe (Siroli, et all, 2020). For instance, in case you have a headache, you are able to use lavender essential oil to the muscles of yours and also the rear of the neck getting fast help, as these’re 2 typical strain areas for headaches.

Reference

Fontaine, K. (2019). Complementary and alternative therapies for nursing practice. (5th Edition) Pearson. ISBN-13: 978-0134754062

Siroli, L., Baldi, G., Soglia, F., Bukvicki, D., Patrignani, F., Petracci, M., & Lanciotti, R. (2020). Use of Essential Oils to Increase the Safety and the Quality of Marinated Pork Loin. Foods, 9(8), 987.