Departmental Impact on Healthcare Reimbursement - Essay Sample

Introduction

Policies and practices for reimbursement are necessary for considerations especially in aspects of research and development for the healthcare organization in terms of decisions made by the potential innovators for technology areas and the financing investors. Reimbursement is a significant factor that helps to determine the kind of products to be offered for development and access to such products that will be used by the care providers and also patients. Organizations that tend to have decentralized methods of making decisions, no pricing that is regulated by the government and also lacks restrictions tends to create an environment which provides for higher levels of expenditure.

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Impact of Departments

It is held that the management of the process of reimbursement has an effect on the general profitability of the healthcare organization. With proper decision-making from the involved departments, the organization is able to know how to source products with other types of innovations that patients will enjoy.

However, for the case of St. Joseph's health, a non-profit organization, reimbursement activities in departments will ensure effective development of products with the evolving roles of drugs and devices (Britton, 2015). These scientific discoveries, as well as the perceptions from the clinical needs, are significant factors affecting innovation.

The healthcare center will be able to invest in the development when there are controls and limits in reimbursement where they will also have concerns for the aspects of future access to the market for the approved products. In the case where there is no proper management of reimbursement in the departments, there will be an increase in the costs of billing and also an increase in accounts receivable as a result of the rates of collection.

The expenditures of drugs and use of devices tend to account for a small share of the overall expenditure of healthcare (Britton, 2015). However, absolute amounts for the same tend to be large which will then have an impact on the costs of healthcare in other areas. Thus, it will make the value of acquisition to be unattainable.

St Joseph's should ensure effective management of departments that deal with reimbursement because they will help the organization to acquire a site-level control hence establishing a lasting and close relationship with patients and also physicians.

The presence of regular audit checks for the departments will be necessary to ensure that there are accurate and full systems for coding put in place. The billing of reimbursement is normally dependent on timely and precise use of the HCPCS codes which will eventually ensure success in the facility. The periodic follow-up audits will also be excellent to ensure that all procedures are in place for dealing with issues on quality and processes of billing.

The impact of these departments on pay-for-performance incentives can be measured by the use of experimental design with an empirical analysis which will involve the envelopment of data estimation. The method will be necessary to show the healthcare policy implications for the study hence determining the levels of efficacy and financing models.

Activities of Each Department

The healthcare administration is varied and all departments are involved in making day-to-day and long-term decisions which tend to reflect the strategies of the facility (Britton, 2015). St Joseph's health is a dynamic institution which combines the health policies and science to ensure appropriate management of resources and the healthcare administrators must strive to ensure improvement in healthcare generally for quality care of patients.

The human resources department is concerned with the management of staff for the department ensuring that activities run smoothly and workers pay is due on time. The financial management is a critical department for the facility because it affects the reimbursement of the center in all ways (Britton, 2015). They make an analysis of any forms of rising healthcare costs and ensure that resources are allocated where they are needed. The data collection and analysis department is responsible for maintenance of functions for the organization by ensuring they take care of competing values for vulnerable points of the facility.

Billing and Coding Policies

The responsible department for ensuring compliance with billing and coding policies is the health information management team. It has the responsibility of assigning the accurate codes that give a reflection of the care level as documented in the record of patients (Britton, 2015). The department has an effective compliance program detailing the elements that should be put down and has been incorporated in the facility to monitor the operations of the hospital system hence ensuring that they are in line with billing and coding procedures.

It affects the impact of the department on reimbursement in that there is the existence of error-free accuracy which helps the organization to efficiently assess the cycle of revenue and also ensure to keep the bad debt at its minimum point considering it a non-profit organization (Britton, 2015). The department makes sure that it tries its best to eliminate any form of avoidable mistakes when it comes to documenting and billing because, at the end of the day, the staff needs their wage.

Reference

Britton, J. R. (2015). Healthcare Reimbursement and Quality Improvement: Integration Using the Electronic Medical Record: Comment on "Fee-for-Service Payment - an Evil Practice That Must Be Stamped Out?" International Journal of Health Policy and Management, 4(8), 549-551