CMS Regulations To complete this discussion: Identify a scenario that would be i
ID: 124511 • Letter: C
Question
CMS Regulations
To complete this discussion:
Identify a scenario that would be impacted by Centers for Medicare and Medicaid Services (CMS) regulations.
An example would be an unexpected complication during or immediately after a patient's hospitalization, which might have been prevented.
Discuss the economic impact of recent CMS regulations with respect to documentation, billing, and reimbursement for services.
Additionally, address how these impacts affect your current role or the future role to which you are aspiring, in the healthcare industry.
Explanation / Answer
Scenario:
In any section of healthcare department cases of non-compliance of important activities or any health realted activities should be reported to the compliance department by the time it is detected. The best decision in the scenario of doubt is to report it soon as possible so that corrective action can be taken within the time frame.
Compliance department consist of trained officers who can conduct investigation of the matter and then they will take relavant action in order to improve the scenario under rules and regulation of conduct, policies and procedures.
PartB: unexpected complication during or immediately after a patient's hospitalization can be prevented by reporting of the case before the symptoms of the pain or injury is out of control. Ambulance facility and service within time is important as physician will get some time to handle the case and doing the correct treatment to control the situation of complication.
PartC: Documentation: Documentation plays a significant role about the quality maintainance and patient service. Either maintaing a soft copy or hard copy about the samples and processing details need to be maintained on the daily basis. Documentation is important for patient history tracking too that helps a physician in handlng the case when patient approach the physician for follow up.
billing: correct billing with patient history information collection are done in most of the organization through EHR system.
reimbursement of services:Daily updates in maintaince of health related services in order to provide better facility for patients are done. Such as patient enrollement, coverage assesment, patient fiancial support, ongoing support etc.
Currently shifting healthcare organization to a plan of EHR system is going to benefit much security for patient document. Paper work will be less and chances of missing important documents will be lesser. Work will be more organised on the daily basis and performing task for healthcare member will be easier.