Determine policies and procedures to monitor abuse or fraudulent trends Evaluate at least three (3) types of abuse or fraud that may occur within a health information management department.
Determine at least three (3) organizational policies and procedures that monitor such activities and critique the effectiveness of each policy/procedures.
Instructions
You are a healthcare executive for a large hospital, serving as the Director of Health Information. There are
serious concerns regarding the competence of your healthcare staff. To address these concerns, you will
develop an action plan. Please complete each part of your action plan as indicated below.
Part Competency Assessed Instructions
1 Determine policies and procedures to monitor abuse or fraudulent trends
Evaluate at least three (3) types of abuse or fraud that may occur within a health information management department. Determine at least three (3) organizational policies and procedures that monitor such activities and critique the effectiveness of each policy/procedures.
2-Create and implement staff orientation and training programs
Based upon the identified trends of abuse or fraud, develop a staff orientation and training program for medical billing and coding employees. Design an outline of the program–constructing the learning activities involved. Your plan should indicate a leadership approach that you would use in the implementation of the program.
3-Evaluate initial and ongoing training programs
Develop a plan to evaluate the training program at “time of launch” and then at periodic times over the next two years. Appraise the effectiveness of our training program evaluation plan.
4 Facilitate the use of enterprise-wide information assets to support organizational strategies and objectives
Analyze the enterprise-wide information assets that you need to support organizational strategies and objectives. Differentiate at least three (3) assets and their role with ensuring quality healthcare. Please include the relationship of the asset to information management planning, enterprise information management, and/or master data/information management.
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