Corporate Compliance

/in /by

In today’s fast-paced academic environment, students often find themselves juggling multiple responsibilities, from attending classes and working part-time jobs to participating in extracurricular activities. The demands of modern education can be overwhelming, leaving students in search of effective solutions to manage their academic workload efficiently. One such solution is the use of Nursingpapertutors.com academic writing website. Nursingpapertutors.com academic writing website employ a cadre of experienced and knowledgeable writers who are well-versed in various academic subjects and writing styles. Nursingpapertutors.com professionals bring a wealth of expertise to the table, enabling them to produce well-researched and well-structured papers that meet the academic standards and expectations of students. Their familiarity with diverse subjects ensures that students can receive assistance across a wide spectrum of disciplines, from mathematics to literature, and from nursing to engineering.

 

You are a corporate compliance officer for a hospital.  You are also a feature writer for The Medical Reporter, an online health magazine.  The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your “hotline” regarding a potential fraud and abuse issue.  The caller indicated that Dr. Greedy was billing for services that had not been provided.  You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped.   Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues.  Your research should include the following aspects:

    1. How to conduct an investigation.  It should include the following elements:

 

      1. Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
      2. Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
      3. Obtaining additional information as necessary and developing a plan for the investigation:  What other items are important to the investigation?
      4. Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
      5. Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.

 

    1. How to develop a correction action plan. The plan may suggest: 

 

    1. A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
    2. A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.

 

 

Assignment 1 Grading Criteria 

Maximum Points

Discussed the process for reviewing the initial healthcare fraud and abuse complaint and the items to look for to determine validity.

36

Explained the steps to take to determine who is involved in the complaint.

32

Discussed how to obtain additional information to develop a plan for the investigation and the items, which would be important to the investigation.

32

Explained how to conduct interviews with staff, residents and/or management and the types of questions to ask in the interview.

32

Identified the criteria to determine if the allegations are substantiated or unsubstantiated.

32

Explained how to determine when a recommendation for a subsequent audit or follow-up to the complaint is necessary.

36

Discussed the best course of action when a recommendation to refund any overpayments to federal government, insurance company or individual payer is warranted.

36

Written Components:
Style (8 points): Tone, audience, and word choice
Organization (16 points): Introduction, transitions, and conclusion
Usage and Mechanics (16 points): Grammar, spelling, and sentence structure
APA Elements (24 points): In text citations and references, paraphrasing, and appropriate use of quotations and other elements of style

64

Total:

300

 

 

One of the significant challenges students face is time management. The demands of coursework, assignments, and exams can create immense pressure, leading to stress and a potential drop in academic performance. Nursingpapertutors.com academic writing website can be a valuable resource for students seeking to balance their responsibilities effectively. By outsourcing some of their academic tasks, students can free up time to focus on studying, participating in meaningful extracurricular activities, or even addressing personal obligations. This improved time management can alleviate the stress associated with academic overload. The ultimate goal of education is to enhance one’s knowledge and skills. Nursingpapertutors.com academic writing websites can play a vital role in achieving this goal by providing students with well-crafted papers that serve as models for their own work. These papers can offer valuable insights into effective research, organization, and writing, thereby empowering students to improve their academic performance over time.

 
Do you need a similar assignment done for you from scratch? We have qualified writers to help you. We assure you an A+ quality paper that is free from plagiarism. Order now for an Amazing Discount!
Use Discount Code "Newclient" for a 15% Discount!

NB: We do not resell papers. Upon ordering, we do an original paper exclusively for you.