TRICARE is the healthcare provider for active or retired military

Introduction:

TRICARE is the healthcare provider for active or retired military personnel. It also covers the family of these persons. There are a variety of plans and qualifications that go along with this coverage. In order to understand TRICARE, it is important to understand the benefits available and to whom they are available.

Tasks:

  • Summarize the benefits of TRICARE for an active military person.
  • What if the active military person has family?
  • Describe the benefits if the active military person is overseas.
  • What if the active military person overseas brings family?

Discussion – You have been hired as a marketing consultant

Discussion

Prior to beginning work on this discussion forum, read Chapters 8 and 9 of the textbook.

You have been hired as a marketing consultant in your company, or a company or public service organization of your choosing. The organization is asking you to identify a sample population to determine the demand for a product or service they are planning to offer. You will need to provide an unbiased sample survey that best represents the population.

In your post,

  • State the organization’s industry or purpose.
  • Identify the product or services selected for conducting the survey.
  • State the problem that the product or service will solve.
  • Explain what the organization wants to learn about the product or services from the survey.
  • Explain how and where you determined your sample population and why your sample choice will get you the data you need.
  • Determine a sample size that will adequately represent the population for your example and how you determined this is an adequate sample size in your survey.

The Prospective Payment System of CMS consists of thirteen

Introduction:

The Prospective Payment System of CMS consists of thirteen schedules that allow the calculation of payment for a patient encounter. The DRG or price-based system covers inpatient charges from one of these schedules.

Tasks:

  • Describe the schedules of CMS.
  • Provide an example of a charge for each schedule.
  • Describe the case mix concept that alters payment rates.
  • Describe the diagnosis related group payment system.

Claims management is the art of consolidating, billing, filing

Claims management is the art of consolidating, billing, filing, revising, and managing medical claims, an imperative aspect of the healthcare industry. Medical facilities cannot receive due funds if patients are unaware of how much they need to pay. Ensuring provider organizations understand the fundamentals of medical billing and coding can help providers and other staff operate a smooth revenue cycle.

Tasks:

  • Explain some of the common medical billing and coding challenges/issues.
  • Explain the impact of improper claims management.
  • Describe how technology can be helpful when it comes to medical billing and what tools are available.