Risk Management in a Healthcare Organization 10-15 Pages APA Format
This final draft represents Part 1 and Part 2 of the Key Assignment. You should treat it as a finished document in terms of grammar, formatting, references, all necessary sections, and complete content. There is also a Part 3 to this week’s assignment related to implementing the training of new staff with the completed Training Manual.
Part 1 Tasks (from Week 4)
In this assignment, you will develop a training manual that will be utilized for training new employees (certified medical administrative assistants [CMAAs]) who join the clinic.
Physicians are hiring more CMAAs to help manage the increasing complexities of patient care and practice management, while also helping to implement cost-effectiveness and efficiency. Your responsibilities as a CMAA can be tailored to the needs of the practice. You will manage front-office functions, manage patient flow, and handle a wide range of tasks that have been discussed in the past few weeks. As a CMAA, you may convey clinical information on behalf of the physician and follow clinical protocol when speaking with patients, but you cannot exercise independent medical judgments. You will also help to optimize patient flow, enabling the physician to see more patients with efficiency, all while following your State’s scope of practice and working under the supervision of a licensed physician.
Note: Content from Weeks 1–4 IPs and DBs can be wholly or partially used as necessary to address the specific Key Assignment tasks shown below. You should take into account any instructor feedback from those IPs and DBs.
The project deliverables are as follows:
Course number and name
Project name (“Training Manual”)
The training manual should include the following topics:
Introduction to the health care facility
Explain the mission and services provided by the facility
Explain the type of healthcare delivery model that this facility represents and the difference between this model and that of other facilities in the same region
The organization’s structure
The Practice Management System and other Software Systems
Description of the practice management system
The administrative role of the practice management system
The role of the practice management system in billing and coding
The process of checking patients in and out
Recording patient demographic and insurance information
HIPAA forms to be reviewed with first time patients
HIPAA rules and regulations to protect patient privacy
Interacting and communicating with patients professionally
Other Office Procedures related to Patient Care
Various community and patient resources
Receive, triage, and route phone calls
Medical Record Responsibilities
Office procedures and guidelines for various forms of documentation (Release of Information and use of the electronic health record)
Financial procedures related to the policies of the organization
Accounting and bookkeeping procedures and processes Financial procedures related to the organization’s cash flow
Description of 2 or more reimbursement models used in the facility, e.g., fee-for-service.
Billing policy and procedures
Claims for reimbursement – submission processes and procedures
Review records for medical necessity
Clean claims submission and use of the Clearinghouse
Part 2 Tasks (Week 5)
In this assignment, you will add a final section, “Risk Management”, to your training manual that will be utilized for training new employees (CMAAs) who join the clinic.
As a CMAA in a clinic, you are responsible for ensuring that job performance is in compliance with regulatory agency guidelines. There are many areas of compliance that a CMAA must be familiar with: financial risk, local and state regulations, Occupational Safety and Health Administration (OSHA), transmission and release of information, HIPAA guidelines, patient care procedures, and prevention of medical errors. For this part of the assignment, you will add the following topics to your training manual:
Identify and discuss 3 compliance risks.
Indicate the consequences of not meeting these requirements.
Add a conclusion that should include the guidelines or policies that should have been followed to prevent this infraction.
Part 3 Task (Week 5)
As the manager of the healthcare facility and supervisor for the office staff, you must plan for the implementation of staff training using the Training Manual.
Create a plan for implementing use of the Training Manual to make sure that the office is run efficiently and effectively. Consider how you will use this Manual to train staff, assess their completion of training and continuously update training for staff. Write a one page memo to the Physician Director of the Practice describing your plan.
Note: you should include a minimum of 3 references in your training manual.
All sources should be cited using APA formatting.
Grammar, spelling, punctuation, and format should be correct and professional.