HSM 541 Week 7 Discussion Question 1: Fraud and Abuse (GRADED)

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HSM 541 Week 7 Discussion Question 1: Fraud and Abuse 7-1 Discussion: Fraud and Abuse Fraud and abuse to seem at an all-time high and hospitals having more and more rules to ma... ke for sure that enforcing penalties is done and taken seriously. This has really made it a lot easier and less gray areas than used to be over the years. CMS really has helped by knowing and also recognizing certain signs of fraud and abuse by the use of beneficiaries. The reason CMS has created programs is to make for sure that individuals know what fraud looks like and how to avoid giving out Social Security numbers or any type of healthcare numbers such as Medicare to people that might take advantage of this and do negative things. IT departments have relationships with each department and work to make for sure that coding procedures are done correctly to improve the financial departments and also reduce frauds and self-doubt of systems that fail. These systems are very essential to the modern-day hospitals and it can literally be a matter of life and death if they stop working effectively. IT departments are also responsible for desktop support and running the help desk. The support staff working in this area doesn’t generally require a clinical knowledge, but support the computers, laptops, printers and other devices in a hospital. Desk Alerts is a unique internal communications software solution that sends mass notifications to users in the form of pop-up notifications to all PC screens in an organization. That way it can be used to let everyone know at once if there is a known issue, taking pressure off help desk staff. Laws and regulations are to protect everyone this even goes for patients and providers in healthcare. HIPPA regulations are to make for sure that compliance officers are making for sure that poor physician documentation is very minimum and also that all healthcare departments and hospitals know rules and regulations about fraud and abuse. Facilities and their departments should know and also dedicate all information and patient wellbeing around compliance and policies and procedures. References: 1. Harrington, M. K. (2016). Health Care Finance and the Mechanics of Insurance and Reimbursement. Burlington: Jones and Bartlet Learning. Replies Great Post Shantell ! I completely agree that Fraud and abuse to seem at an all-time high and hospitals having more and more rules to make for sure that enforcing penalties is done and taken seriously. This has really made it a lot easier and less gray areas than used to be over the years. CMS really has helped by knowing and also recognizing certain signs of fraud and abuse by the use of beneficiaries. The reason CMS has created programs is to make for sure that individuals know what fraud looks like and how to avoid giving out Social Security numbers or any type of healthcare numbers such as Medicare to people that might take advantage of this and do negative things. IT departments have relationships with each department and work to make for sure that coding procedures are done correctly to improve the financial departments and also reduce frauds and self-doubt of systems that fail. These systems are very essential to the modern-day hospitals and it can literally be a matter of life and death if they stop working effectively. I personally think that Laws and regulations are to protect everyone this even goes for patients and providers in healthcare. HIPPA regulations are to make for sure that compliance officers are making for sure that poor physician documentation is very minimum and also that all healthcare departments and hospitals know rules and regulations about fraud and abuse. Facilities and their departments should know and also dedicate all information and patient well-being around compliance and policies and procedures. Michael, Great Information! I agree CMS really has helped by knowing and also recognizing certain signs of fraud and abuse by the use of beneficiaries. The reason CMS has created programs is to make for sure that individuals know what fraud looks like and how to avoid giving out Social Security numbers or any type of healthcare numbers such as Medicare to people that might take advantage of this and do negative things. IT departments have relationships with each department and work to make for sure that coding procedures are done correctly to improve the financial departments and also reduce frauds and self-doubt of systems that fail. These systems are very essential to the modern-day hospitals and it can literally be a matter of life and death if they stop working effectively. IT departments are also responsible for desktop support and running the help desk. The support staff working in this area doesn’t generally require a clinical knowledge, but support the computers, laptops, printers and other devices in a hospital. I personally think that Laws and regulations are to protect everyone this even goes for patients and providers in healthcare. HIPPA regulations are to make for sure that compliance officers are making for sure that poor physician documentation is very minimum and also that all healthcare departments and hospitals know rules and regulations about fraud and abuse. Facilities and their departments should know and also dedicate all information and patient well-being around compliance and policies and procedures. [Show More]

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