topic

Please help incorporate peer review article with grammar check

Providing care with limited reimbursement

You are the manager at a home health agency. One of your elderly patients has insulin-dependent diabetes. He has no family support. He speaks limited english and has little understanding of his disease. He lives alone. Your reimbursement from a government agency pays $90 per visit. Because this gentleman needs so much care, you find that the actual cost to your agency is $130 for each visit to him.

1. What will be the impact to your agency if this patient is seen twice a week for three months?

2. How can you recover the lost revenue?

3. How can you make each visit less costly and still meet the needs of the patient? Support using one peer reviewed nursing article and your text book.

PAPER

need help incooperate artilce in paper/grammer check

https://pubmed.ncbi.nlm.nih.gov/26817266/ <------- peer review article

Home health facilities are a clinical rehabilitation organization delivered by a certified rehabilitation physician, occupational therapist, physical therapy, or other trained medical providers. They are frequently suggested in the process of hospitalization as part of the treatment package. It offers a broad variety of services that can also postpone the need for long-term treatment. Studies also have shown that the burden of treating chronic conditions is reduced by treatment consistency. It leads to stronger communication between the patient and the doctor. The doctor also knows the patient background well in terms of treatment quality. It helps to identify and diagnose some diabetes-related symptoms early.

In this present scenario, one of these elderly patients is suffering from insulin dependent diabetes and no family support and living lonely and speaks limited English and has little understanding of the disease he is suffering. For home health care agency, as government reimbursement of $90 per every visitation, he needs a lot of care according to his condition. $130 is the actual cost that is required for each visit. This man needs a lot of care twice a week for 3 months. If the patient is seen twice a week, a government reimbursement is $90 for every visit, and agency actual cost is $130 for every visit. This leads to a financial burden on the home healthcare agency. This is so because this is a private entity that needs to meet patient demands and staff. The staff has to be paid for their services.

The cost-shifting procedure could restore lost revenue. The hospital charges two separate payments on two distinct classes for the same care. The well-off group of patients spends extra for the care which compensates for the money that the hospital has missed. As a manager, I would pick a billing company who can rapidly make correct, facilitate the repayment system, minimize the amount of outstanding or rejected claims, or hire billing professionals with home health specialist experience and can bill multiple payers, including Medicare, Medicaid, and exchange insurance, and ensure that the revenue cycle is going smoothly. Comprehensive predictive technology could be chosen as it helps the home health billing providers insight into financial service organizations by detecting patterns, finding missed sales prospects, and incorporating payer-specific information. Best billing agencies could be allowed to partner with home health departments to restore missing reclamations to ensure that the facilities they deliver are adequately accounted for. Medicare covers a wide range of services to ensure it meets its beneficiaries' health needs, including reimbursement for a health care agency.

The health care agency manager can also opt for;

Right arrow acute billing which turn around fast. It can choose a billing company that is able to be able to surrender to quickly clean and precise claims. It can also speed up reimbursement process thereby reducing unpaid claims or denial claims.

Right arrow billing expertise, the healthcare agency should contain staff billing experts with appropriate knowledge who can poster a number of financiers that include Medicaid, Medicare thus ensuring smooth running of the revenue cycle.

Right arrow web based analytical technology, billing companies offer complete analytic technology that provides intuition financial matters of the intervention financial health by observing tendencies identifying lost chances and enhancing payer-specific analysis.

Right arrow billing recovery will specialize at managing the due entitlements and aged accounts. Top billing companies will toil hand in hand with home-based healthcare agencies to recuperate some lost entitlements for poor services and payment provided.

By approaching through these methods, the agency can regain and bring back lost revenue.

Early diagnostic diagnosis decreases the additional hospital costs. They utilize billing skills to charge a range of payers such As Medicare and Medicaid because the home health provider's payment would be paid by Medicare to satisfy beneficiaries' demands. Physicians may decrease the expense of treating by recommending a low-priced form, such as generic medicine rather than an advertised drug. If there is not a safe alternative, a cheaper substitution should be recommended.