Question

In: Operations Management

Paper (1-2 pages) An Organizational problem you want to investigate/learn more about - A problem where...

Paper

(1-2 pages) An Organizational problem you want to investigate/learn more about

- A problem where you work or

- A problem in a company you read about

(7-8 pages) Research about the problem

- 1-2 Journal articles & textbook

- Summarize your research

(1 page) Make recommendations (these need to follow from the research)

Solutions

Expert Solution

Coding abuse can be very dangerous for an organisation and for its health as it leads out the critical data about the patients as well as different factors of the organisation which can be used by the competitors as well as different malicious factors which could diversity effect organisation

Some strategy to combat decoding frauds are as follows

Reviewing clinical clarification process

This is one of the most effective Strategies for fighting the abuse of coding. By introducing pay per performance programs as well as verification of the specific clarification process can be very beneficial for reducing overall number of frauds. That should be a clarification of acquiring process between the providers and the code us to specifically in sure the surety and alignment of the clinical documentation and coding. A coder must have access to all the quotes he produced and the receiver should also have access to the courts and they should be a confirmation process every once in awhile to maintain a surety about the specific exchange.

These queries can be applied concurrently to help the overall process of clinical coding. This is specific type of strategy also support the overall practitioners as well as different people in the organisation by maintaining the level of secrecy in the data.

Clinical documentations are the main foundation for the practices as well as revenue cycles and clinical understanding of the organisation which includes treatment of the patient this should be accurately maintain and should be provided accurate details as well.

Implementation of a compliance plan

Implementing a document in organisation is one of the most prominent way to stop the abuse of coding. These documents can easily determine the differences between the fraud and actual data by analysing both of the situations. Multiple plans are implemented by the government as well as the private spares for increasingly ensuring that payment for Medical Services are specifically accurate and necessary. By reviewing the payments and locating the overpayments or the intentional frauds which happen inside the organisation by looking into the violation of the building rules which can range from mistake in billing or intentional fraud billing. These plants help to mitigate the intentions of fraud inside the organisation and also provide the support to the overall structure of the organisation.

Self assessment of the organisational structure as well as documentation and coding can be very very fisher for maintaining a clear and transparent working structure and to avoid the fraud.

Implementing EHR

Implementing electronic health record system creates an effective fraud reflecting work environment. As most of the data is collected electronically the number of fraud are reduced automatically. Availability of the data and availability of the data in a single click make it more easier to detect the specific fraud inside an organisation and to carry out the conduct on the abuse of coding. Implementation of record also helps an organisation to ensure the overall treatment as well as different information flow inside an organisation by a specific floor which can be very beneficial for an organisation to maintain the productivity as well as efficiency while fighting the frauds.


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