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MHA-FPX5006

MHA FPX 5006 Assessment 4 Operating Budget Proposal

MHA, MHA-FPX5006 /

MHA FPX 5006 Assessment 4 Operating Budget Proposal MHA FPX 5006 Assessment 4 Operating Budget Proposal Student Name Capella University MHA-FPX 5006 Health Care Finance and Reimbursement Prof. Name Date Operating Budget Proposal Healthcare institutions must develop operational budget plans to accurately forecast revenues and expenditures. This process ensures that medical objectives are met while achieving anticipated profitability (Saviano et al., 2018). Presented here is a comprehensive operating budget proposal for a healthcare organization, including expenses for acquiring a billing system and MRI equipment to enhance operations. Environmental Factors Affecting the Operational Budget Various environmental factors, whether direct or indirect, impact a healthcare organization’s annual budget. Internal strategic elements such as employees, organizational structure, finances, and values significantly influence budget considerations. Effective governance, financial stability, and workforce competence are crucial for meeting organizational goals (Krastanov et al., 2019). Additionally, changes in laws and regulations, like those introduced in the Affordable Care Act, can significantly influence financial prospects for healthcare organizations (Chen & Grabowski, 2019). Proposed Organizational Budget for Improvement The proposed budget includes expenses for acquiring a billing system and MRI equipment to enhance organizational operations. The MRI machine aims to enhance patient care by providing precise imaging, reducing misdiagnoses. Moreover, owning an MRI machine can attract more patients to the hospital, thereby increasing revenue (Faria et al., 2018). The billing system is expected to streamline billing processes, reduce documentation, and improve customer service (Rosenbach et al., 2017). Budget Alignment with Organizational Target Profit Margin The budget aligns with the organization’s goals of increasing revenue and improving patient care. Investments in MRI equipment and billing systems are essential for achieving these objectives. Additional funds are allocated for training and equipment management to ensure that new purchases contribute effectively to organizational goals (Adhikara et al., 2022). Measurement of Financial Performance Implementing performance measurement tools is crucial for evaluating the hospital’s financial success. By tracking qualitative and quantitative metrics, the organization can assess its economic position and make necessary adjustments to improve financial performance (Wang et al., 2018). Regular cost-benefit analyses help monitor monthly changes and establish revenue targets, contributing to the organization’s overall financial stability (Lim et al., 2018). Conclusion A comprehensive operating budget must consider all environmental factors affecting the organization and provide mechanisms for assessing financial performance. By analyzing various financial sectors and adopting long-term budgeting strategies, healthcare organizations can navigate economic uncertainties and ensure sustainable growth (Saviano et al., 2018). References Adhikara, M. A., Diana, N., & Basjir, M. (2022). Organizational Performance in Environmental Uncertainty on the Indonesian Healthcare Industry: A Path Analysis. Academic Journal of Interdisciplinary Studies, 11(2), 365-365. Al Ahbabi, A. R., & Nonane, H. (2019). Conceptual building of sustainable financial management & sustainable financial growth. Available at SSRN 3472313. Berwick, D. M., & Gilfillan, R. (2021). Reinventing the Center for Medicare and Medicaid Innovation. JAMA, 325(13), 1247–1248. Brooks-LaSure, C., Fowler, E., Sihamoni, M., & Tsai, D. (2021). Innovation at the Centers for Medicare and Medicaid Services: a vision for the next 10 years. Health Affairs Blog. August, 12. Cascardo D. (2017). Preparing to Meet the New CMS Emergency Preparedness Rule. The Journal of Medical Practice Management: MPM, 32(5), 301–303. Chen, M., & Grabowski, D. C. (2019). Hospital Readmissions Reduction Program: Intended and Unintended Effects. Medical Care Research and Review: MCRR, 76(5), 643–660. MHA FPX 5006 Assessment 4 Operating Budget Proposal Faria, R., Soares, M. O., Spackman, E., Ahmed, H. U., Brown, L. C., Kaplan, R., Emberton, M., & Sculpher, M. J. (2018). Optimizing the Diagnosis of Prostate Cancer in the Era of Multiparametric Magnetic Resonance Imaging: A Cost-effectiveness Analysis Based on the Prostate MR Imaging Study (PROMIS). European Urology, 73(1), 23–30. Gai, Y., & Pachamanova, D. (2019). Impact of the Medicare hospital readmissions reduction program on vulnerable populations. BMC Health Services Research, 19(1), 837. Krastanov, A., Lăzăroiu, G., Vaganova, L., Kolesnikova, J., Danilova, M., & Malavika, D. (2019). The Effectiveness of Marketing Communication and Importance of Its Evaluation in an Online Environment. Sustainability, 11(24), 7016. Lim, J., Lim, K., Heinrichs, J., Al-Aali, K., Aamir, A., & Qureshi, M. (2018). The role of hospital service quality in developing the satisfaction of the patients and hospital performance. Management Science Letters, 8(12), 1353-1362. Rosenbach, N., Koller, J. M., Earl, E. A., Miranda-Dominguez, O., Klein, R. L., Van, A. N., Snyder, A. Z., Nagel, B. J., Nigg, J. T., Nguyen, A. L., Lesnevich, V., Greene, D. J., & Fair, D. A. (2017). Real-time motion analytics during brain MRI improve data quality and reduce costs. Neuroimage, 161, 80–93. Saviano, M., Bassano, C., Picacho, P., Di Nauta, P., & Lettieri, M. (2018). Monitoring Viability and Sustainability in Healthcare Organizations. Sustainability, 10(10), 3548. MHA FPX 5006 Assessment 4 Operating Budget Proposal Wang, T., Wang, Y., & McLeod, A. (2018). Do health information technology investments impact hospital financial performance and productivity? International Journal of Accounting Information Systems, 28, 1-13. Download Free Sample Get Capella University Free MHA Samples MHA FPX 5010 MHA FPX 5020 MHA FPX 5042 MHA FPX 5040 MHA FPX 5016 MHA FPX 5012 MHA FPX 5014 MHA FPX 5017 Get Free Samples of any Class/Assignment

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MHA FPX 5006 Assessment 3 Cost-Benefit Analysis

MHA, MHA-FPX5006 /

MHA FPX 5006 Assessment 3 Cost-Benefit Analysis MHA FPX 5006 Assessment 3 Cost-Benefit Analysis Student Name Capella University MHA-FPX 5006 Health Care Finance and Reimbursement Prof. Name Date Cost-Benefit Analysis Healthcare facilities are constantly striving to optimize patient care while minimizing expenses. One strategy for achieving this goal is by investing in an MRI device, which not only improves patient care but also attracts more patients to the facility. However, the decision to procure such a device necessitates careful consideration due to its significant cost implications. When conducting a cost-benefit analysis, healthcare facilities must take into account various factors such as maintenance expenses, system upgrades, and personnel training (Phillips Healthcare, 2016). This analysis assists in estimating the potential revenue generated by the investment, thus guiding decision-making processes. Opportunity Cost Understanding the concept of opportunity cost is essential when evaluating investments. While acquiring an MRI machine involves risks and substantial upfront costs, it also offers opportunities for revenue generation and enhanced patient care (Cleverley & Cleverly, 2018). Utilizing a comprehensive cost-benefit analysis, along with an understanding of opportunity costs, ensures a thorough evaluation of available options before reaching a decision. Effective identification of alternatives and forecasting aids in informed decision-making, ultimately leading to improved patient outcomes and increased revenue for healthcare facilities. Cost-Benefit Analysis A cost-benefit analysis serves as a crucial tool for assessing the feasibility of a project, such as acquiring an MRI machine, by comparing anticipated costs with expected benefits (Plowman, 2009). Calculations over a five-year period, considering a present value discount rate of 2%, reveal the potential financial implications of such an investment. While the initial cost of an MRI machine varies significantly, ranging from $150,000 to $1.2 million nationwide (Glover, 2014), the analysis provides insights into the total costs and benefits over the specified timeframe. MHA FPX 5006 Assessment 3 Cost-Benefit Analysis Action Plan Upon conducting a cost-benefit analysis and determining the viability of acquiring an MRI machine, healthcare facilities must develop a clear action plan. This plan should outline steps for procurement, budgeting, and decision-making processes (Chakravarty & Naware, 2008). Additionally, it should address strategies for cost management while ensuring optimal patient care. Regular maintenance schedules and adherence to established guidelines are essential to maximize the longevity of the MRI machine and maintain patient satisfaction. Conclusion In conclusion, the decision to acquire an MRI machine requires careful consideration of both costs and benefits. Through a comprehensive cost-benefit analysis, healthcare facilities can assess the financial implications and potential returns on investment. By accounting for maintenance costs, system upgrades, and personnel training, facilities can make informed decisions that optimize patient care and enhance revenue generation. References Chakravarty, A., & Naware, S. S. (2008). Cost-effectiveness Analysis for Technology Acquisition. Management and Decision Making, 64(1), 46-49. Cleverley, W. O., & Cleverly, J. O. (2018). Essentials Of Health Care Finance (8th ed.). Jones & Bartlett. Glover, L. (2014, July 16). Why Does an MRI Cost So Darn Much? Money. Retrieved from https://money.com/why-does-mri-cost-so-much/ MHA FPX 5006 Assessment 3 Cost-Benefit Analysis Plowman, N. (2009, December 1). Writing a Cost-Benefit Analysis. Retrieved from https://www.brighthubpm.com/project-planning/58181-writing-a-cost-benefit-analysis/ Download Free Sample Get Capella University Free MHA Samples MHA FPX 5010 MHA FPX 5020 MHA FPX 5042 MHA FPX 5040 MHA FPX 5016 MHA FPX 5012 MHA FPX 5014 MHA FPX 5017 Get Free Samples of any Class/Assignment

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MHA FPX 5006 Assessment 2 Proposal for Billing Changes

MHA, MHA-FPX5006 /

MHA FPX 5006 Assessment 2 Proposal for Billing Changes MHA FPX 5006 Assessment 2 Proposal for Billing Changes Student Name Capella University MHA-FPX 5006 Health Care Finance and Reimbursement Prof. Name Date Proposed Changes in the Billing Process and Procedures Automation of the Billing Process As the healthcare industry readies itself for current and future challenges, it is vital for us to maintain a competitive edge by reassessing our existing billing system. This reassessment entails evaluating system efficiency, operational capacity, and billing accuracy. Currently, physicians in our facility manage billing responsibilities instead of employing dedicated medical billing and coding personnel. A comprehensive analysis reveals inefficiencies in this decentralized approach, prompting the necessity to update billing policies and standard operating procedures. To enhance effectiveness and efficiency, our organization must embrace automation and integration in its billing process (Gupta, 2020). Billing lies at the core of healthcare provision and organizational revenue generation, necessitating comprehensive changes. Thus, the following billing adjustments are proposed alongside the recruitment of adequate medical billing and coding staff: Promptly Handle Rejected Claims The clinic should enforce a new policy mandating prompt follow-up on denied claims. Despite automation and proper coding, denied claims remain inevitable. Therefore, establishing a four-week timeframe for medical billers to resolve rejected claims with insurance providers is essential. Clarify the Collection Process to the Patient Transparency in the billing process is crucial for successful medical claims management. Implementing a policy that requires healthcare professionals to educate patients on their financial responsibilities before their initial appointment is essential. This proactive approach ensures patients are informed and minimizes misunderstandings regarding payment obligations. Maintain and Update Integrated Patient Files Consistency in claims necessitates up-to-date patient information integrated across the organization (Gupta, 2020). Healthcare practitioners should verify patient demographics and insurance coverage regularly, especially during insurance changes. This proactive approach ensures accurate billing and minimizes claim rejections. Step-by-Step Revenue Cycle Management Efficient revenue cycle management entails a structured approach: Step Description Patient Registration Front desk staff collect essential patient information for appointment scheduling. Insurance Verification Outsourced billing services authenticate patient coverage, examining policies and eligibility. Patient-Doctor Meetings Recording Documentation of patient encounters assists coders and billers in accurate coding and billing. Medical Transcription Transferring patient meeting data into a format suitable for billing. Medical Coding Assigning clinical codes to transcripts simplifies billing procedures. Charge Entry Billing for services rendered before claim submission to insurance companies. Charge Transmission Submitting claims to payers, either electronically or via government channels. Accounts Receivable Management Monitoring claims post-submission to ensure efficient payment processing. Denial Management Addressing denied claims promptly to rectify errors and expedite reimbursement. Payment Posting Recording payment status and providing Electronic Remittance Advice to patients. Pricing Structure and Insurance Contract Negotiation Utilizing the cost-based pricing method ensures transparency and competitiveness: Pricing Factors: Differentiation, cost analysis, company objectives, and market demand influence pricing decisions (Sanchita, 2021). Negotiating Insurance Contracts: Key considerations include fee schedules, timely payment clauses, and credentialing procedures (Gwilt, 2016). Private Pay and Charity Care The clinic adopts a flat fee for private pay and offers charity care for patients in need (Montgomery, 2020). Billing Software System Implementing cloud accounting software enhances accessibility and efficiency in managing financial data (Sage, 2021). Benefits of Proposed Changes These changes promise enhanced efficiency for the clinic, physicians, and patients alike. Automation streamlines processes, reducing errors and enabling faster service delivery (Minolita, 2016). Patients benefit from improved access to healthcare services and transparent billing practices. Additionally, efficient billing procedures facilitate prompt payments, ensuring financial stability for the clinic. References Gupta, A. (2020). Transforming Healthcare Revenue Cycle Management through Automation. Healthcare Financial Management, 74(6), 30-35. Gwilt, R. (2016). 6 Key Things Medical Practices Should Consider When Negotiating Payer Contracts. Retrieved from https://nixongwiltlaw.com/nlgblog/2016/3/14/jp5r4aew25nu3r9h6joqgku63tab3m MHA FPX 5006 Assessment 2 Proposal for Billing Changes Lumen. (2021). Pricing Methods. Retrieved from https://courses.lumenlearning.com/boundlessbusiness/chapter/pricing-methods/ Mark, A. (2020). 10 Steps of Medical Billing Services for Effective Revenue Cycle Management. Retrieved from https://www.p3care.com/blog/10-steps-of-medical-billingservices-for-effective-revenue-cycle-management/ Minolita, K. (2016). The Benefits of an Integrated Medical Billing System. Retrieved from https://healthcare.konicaminolta.us/news-blog/the-benefits-of-an-integrated-medicalbilling-system/ Montgomery, K. (2020). How to Obtain Charity Care. Retrieved from https://www.verywellhealth.com/how-do-i-obtain-charity-care-173851 Sage. (2021). Accounting made simple with Sage. Retrieved from https://www.sage.com/enke/accountingsoftware/?gclid=CjwKCAjwpMOIBhBAEiwAy5M6YDPiDD66j7QLjab5dQuHnp3Oy_vnVFUjMHuyVw6tU56UKcVayKK7exoCl8AQAvD_BwE&gclsrc=aw.ds MHA FPX 5006 Assessment 2 Proposal for Billing Changes Sanchita, S. (2021). Factors Influencing Pricing. The Art of Marketing. Retrieved from https://www.artofmarketing.org/pricing/factors-influencing-pricing/13831 Download Free Sample Get Capella University Free MHA Samples MHA FPX 5010 MHA FPX 5020 MHA FPX 5042 MHA FPX 5040 MHA FPX 5016 MHA FPX 5012 MHA FPX 5014 MHA FPX 5017 Get Free Samples of any Class/Assignment

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MHA FPX 5006 Assessment 1 Financial Basics

MHA, MHA-FPX5006 /

MHA FPX 5006 Assessment 1 Financial Basics MHA FPX 5006 Assessment 1 Financial Basics Student Name Capella University MHA-FPX 5006 Health Care Finance and Reimbursement Prof. Name Date Financial Basics Revenue for healthcare providers is derived from various sources, each with distinct requirements and reimbursement procedures. Understanding these intricacies is vital for ensuring reimbursement and overall success. The primary revenue sources for providers encompass Medicaid, Medicare, and Managed Care coverages, each governed by specific rules dictating reimbursement, which impact the timing and method of payment for enrollees’ services. This presentation seeks to explore these revenue models, shedding light on their purposes and reimbursement mechanisms. Medicaid Established in 1965 under the Social Security Act, Medicaid offers health insurance for low-income individuals, including the disabled, children, and elderly in need of long-term care. Administered jointly by federal and state governments, Medicaid exhibits variations across states, resulting in coverage disparities. The Affordable Care Act broadened eligibility criteria, facilitating broader coverage and standardizing benefit rules. Medicaid’s reimbursement process is tailored to cover medical services for economically disadvantaged individuals, though it varies by state, posing challenges in comprehension and navigation. Medicaid presents two primary payment models: fee-for-service and managed care. The fee-for-service model reimburses providers for individual services rendered, potentially incentivizing overutilization. Conversely, the managed care model prioritizes overall patient care, allocating a fixed payment regardless of services provided, with the aim of balancing quality and cost-effectiveness. Medicare Initiated in 1965, Medicare ensures healthcare access for individuals aged 65 and above, as well as those with specific disabilities. Managed by the Centers for Medicare and Medicaid Services (CMS), Medicare comprises Parts A, B, C, and D, each covering distinct services. Reimbursement under Medicare involves appropriately coding services according to each part’s requirements, with claims processed by Medicare Administrative Contractors (MACs). Reimbursement mechanisms differ among parts, influencing provider reimbursement and patient responsibility. Managed Care Managed care plans collaborate with providers to deliver cost-effective care, emphasizing patient wellness and preventive measures. Three common types include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (POS) plans, varying in flexibility and cost-sharing. Managed care reimbursement hinges on reducing unnecessary services and clear payment mechanisms outlined in contracts. Payment methodologies encompass risk-based payment, percentage of premium, global fees, capitation, and discounted fee-for-service, each impacting providers’ revenue streams and care delivery. MHA FPX 5006 Assessment 1 Financial Basics Conclusion The revenue models discussed are pivotal for healthcare organizations’ financial sustainability and the quality of patient care. Understanding and navigating reimbursement processes ensure providers deliver optimal care while maintaining financial viability, thereby fostering long-term organizational resilience. References Centers for Medicare and Medicaid Services. (n.d.). Program History. Retrieved from Centers for Medicare and Medicaid Services Hurley, R., & Retchin, S. (2006). Medicare and medicaid managed care: a tale of two trajectories. The American Journal of Managed Care. Mandelbaum, B. (2015, September 30). Understanding medicaid reimbursement. Retrieved from McKnights Long-Term Care News Matchinski, J. (2006, September). Managed care contracts and your practice. Retrieved from American Academy of Orthopedic Surgeons MHA FPX 5006 Assessment 1 Financial Basics Shea, K. (2018). Course 6: medical billing for medicaid/medicare. Retrieved from Medical Billing and Coding Online Download Free Sample Get Capella University Free MHA Samples MHA FPX 5010 MHA FPX 5020 MHA FPX 5042 MHA FPX 5040 MHA FPX 5016 MHA FPX 5012 MHA FPX 5014 MHA FPX 5017 Get Free Samples of any Class/Assignment

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