COMPETENCIES 737.4.4 : Coding and Finance The graduate evaluates the financial a

by | Jan 13, 2022 | Other | 0 comments

737.4.4 : Coding and Finance
The graduate evaluates the financial and legal impact of accurate billing and coding for pharmaceutical services in a healthcare system.
Proper documentation is an important issue and area of concern to the health information management (HIM) professional. Quality of care, patient safety, and regulatory compliance are major focal points for all healthcare organizations. Health information management professionals serve as subject matter experts to ensure that clinical practices meet the requirements of external regulatory agencies as well as internal stakeholders. Health information management professionals can share their expertise by collecting and analyzing financial and clinical data that relate to the pharmacy department. The goal is for health information management professionals to be familiar with how pharmaceuticals impact reimbursement and with related standards surrounding pharmacy best practices.
You are a clinical documentation improvement coordinator and a liaison to the HIM department. You are reviewing the record for a discharged patient that you received for review due to a rejected claim. You notice that there is documentation of medications administered to the patient in the progress note indicating blinatumomab infusion. However, the medication reconciliation section in the EHR states blood infusion. As you continue to look through the patient record, you confirm that blinatumomab is the correct infusion and note that the correct infusion is billable for $6,900 more than the blood infusion. You look through your database and find that this same error happened six other times this year. Since there is a pattern for blood infusion being coded and billed for blinatumomab infusion, you pull up the medication reconciliation section of the EHR and discover that there is a drop-down box for infusions, and the choices are alphabetized. Blinatumomab infusion comes right before blood infusion. You have brought this issue to the attention of your supervisor. Your supervisor has asked you to provide a report for senior management regarding the error, recommend a corrective action plan, and discuss further legal issues and responsibilities for HIM professionals.
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. A. Analyze the above scenario, and write a report for senior management discussing the financial, quality-of-care, and legal issues related to incorrect medication entry and incorrect billing by doing the following:
1. Discuss the financial impact on the hospital when errors like the one described in the scenario occur.
2. Discuss the quality-of-care and legal issues related to the data-entry error described in the scenario.
3. Recommend a corrective action plan to ensure that the error described in the scenario does not recur.
B. Explain the legal requirements for pharmaceutical reimbursement by doing the following:
1. Discuss the application of the National Drug Code (NDC) to the coding function.
2. Explain the steps an HIM professional should take to report suspected fraud and abuse in collected data.
3. Explain the importance of a pharmacy revenue cycle internal audit based on the scenario.
4. Discuss three important points that should be considered when conducting a pharmacy revenue cycle internal audit.
a. Justify why these points are important to consider.
C. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.


Timely Delivery

All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.

Affordable Prices

Top Quality Papers

We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university, or professional, and we will assign a writer who has a respective degree.

24/7 Support

Our support agents are available 24/7 and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.

100% Plagiarism Free

Plagiarism is the biggest crime in the academic world. We have strict measures to ensure that all the essay papers are written from scratch to maintain originality and avoid plagiarism.

Professional Writers

We have hired a team of professional writers who provide expert essay help. Most of them are native speakers and PhD holders who are able to take care of any assignment you need help with.

We Protect Your Privacy

Anonymous Communication

We offer nameless communication between clients and writers. We value privacy on both sides.

Secure Payments

We do not collect or store any payment information. The order form is protected using SSL 256-bit encryption.

Personal Data Protection

Your personal information remains private and secure under our comprehensive privacy policy. We strictly follow the rules.

Why Us?

Exceptional quality, professional writers, secure and private, always on time. This is how our clients described their experience working with us. We value our clients above all and strive to uphold the high standards that we have set.

Quality is everything. We make sure that each completed paper that we send is an absolute masterpiece. It is well-written, thoroughly thought out, follows guidelines, has impeccable format and completely original. You can be confident that your paper is one-of-a-kind because we double-check it for plagiarism. Your instructor will be impressed when you turn in your paper.


Our Team has special quality assurance team guarantees that all the papers are plagiarism-free and meet the standards or specific requirements of certain academic institutions (these may vary, you know, and they may vary even between different teachers). Upon placing an order, you can communicate with your writer during the entire process and even after it is completed. This ensures a customized service, meeting the exact needs and expectations of any, even the most demanding customers.

Contact Us

Get Started