What is the role of joint commission to obtain deemed status

Reference no: EM133515545

Problem

Part I

A. Medicare is a large payer of health care services as the health care payer for the elderly.

1. Evaluate the Conditions of Participation (CoP) for a hospital to participate with Medicare. What are the pros and cons of a hospital being a Medicare provider? What are the consequences of non-participation with Medicare?

2. What is the role of the Joint Commission to obtain "deemed" status? Is Joint Commission a regulatory agency? Why or why not?

B. Discuss the COSO framework for internal controls and evaluate how it could be used to meet Medicare CoP. Be specific and demonstrate understanding of the risks and how the compliance tool can be used specifically to control the risks.

Part II: Strategic Compliance with the Law

You work for a small managed care organization (MCO) "Splendid Healthcare" that owns a hospital and two provider clinics in. Your MCO just received notice that it will be subject to a CMS Recovery Audit Contractor (RAC) audit on the following issues and has requested medical records from your hospital and provider clinics.

1. 0001 Inpatient Hospital MS - DRG Coding Validation
2. 0011 Inappropriate Billing of Home Visit Professional Service Evaluation and Management Codes during Inpatient

A. Name and describe the law and code section that gives CMS and RAC auditors the right to access your medical records. (Give the legal source of the right)

B. Your records are electronic, but not transferrable electronically in an interoperable fashion. How could you best meet the medical record request?

C. Discuss interoperability requirements. How could you prepare to have an interoperable electronic health record (EHR) that meets CMS standards? Describe the steps you would take to move towards interoperability.

Reference no: EM133515545

Questions Cloud

How are the products of photosynthesis : How are the products of photosynthesis and cellular respiration related to the process of muscle contractions in animals?

What is the principal diagnosis code : John Brennen, a 7-year-old male, is brought in by his parents. What is the principal diagnosis code? What is the second diagnosis code?

What human structure is analogous to the yolk : The procedure indicates that the albumen can be used to provide protein to the growing egg. What other purpose might this layer serve?

Compare the ways that state and local governments can work : Compare the ways that state and local governments can work with healthcare organizations to foster integration between primary care and public health.

What is the role of joint commission to obtain deemed status : What is the role of the Joint Commission to obtain deemed status? Is Joint Commission a regulatory agency? Why or why not?

Why is carbon dioxide considered the main greenhouse gas : Why is carbon dioxide considered the main greenhouse gas? Why are carbon dioxideconcentrations increasing in the atmosphere?

Compare how this specific ich guideline has impacted : Compare how this specific ICH Guideline has impacted the regulations, agency guidance documents, and literature in one country or region internationally.

Impact of different ph levels on plant growth : How can i Design an experiment testing the impact of different pH levels on plant growth.

What is the website to renew through : What is the cost to renew? What is the website to renew through? What is the duration of certification? What is the process to renew?

User Account

All Pages