Discussion 2 - Imagine that a hospital in the United States

Question # 00855325 Posted By: wildcraft Updated on: 05/31/2024 02:24 AM Due on: 05/31/2024
Subject Law Topic General Law Tutorials:
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Discussion 2

Imagine that a hospital in the United States has recruited a billing specialist who reports to the manager of the billing department. The responsibility of the billing specialist is to ensure compliance with billing policies and procedures. The manager has begun an audit of the department's adherence to policies and procedures. The audit reveals that the recently recruited billing specialist is not following the standard billing guidelines. In several patient bills, the manager observes billing errors and noncompliance with the hospital's standard process. After investigation, the manager determines that it is fraudulent billing.

In your initial post, include the following:

  • Identify the legal and compliance implications of the billing specialist's actions.
  • Describe how you believe the manager and hospital should respond to this issue.
  • Describe the measures the hospital should take to prevent the recurrence of this issue.

 

 Reading: Essentials of Health Policy and Law, Chapters 2, 3, and 12 

Textbook link:https://bncvirtual.com/vb_econtent.php?ACTION=econtent&FVENCKEY=AD9EE8D798DCAFC7E76B5FB7C978DD86&j=43766531&sfmc_sub=1597096465&l=23329524_HTML&u=695880241&mid=524003857&jb=40753&utm_term=10242022&utm_source=transactional&utm_medium=email&utm_campaign=Direct_Ebooks

 

Article:https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/MLN4649244

Article: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency

Article: https://healthcare.uslegal.com/liability/

Article:https://www.hanover.com/businesses/business-customer-resources/hanover-risk-solutions/identifying-risks-healthcare

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  1. Tutorial # 00850812 Posted By: wildcraft Posted on: 05/31/2024 02:24 AM
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