Task summary: Write a paper, 6 pages APA-style. Examine the steps of the revenue cycle, explain how to evaluate the financial condition of a healthcare organization, as well as take a closer look at the financial decision-making process, federal fraud. Use at least 6 academic sources.
Full order description: ? MAIN DETAILS:
A. Explain the activities of each step of the revenue cycle in the order they occur.1. Describe the work of health information management (HIM) staff members during each step of the revenue cycle in which they would be involved.2. Explain how coding and billing cycle processes impact healthcare organization revenue cycles.3. Explain how the operating revenue impacts the revenue cycle.
B. Explain how to evaluate the financial condition of a healthcare organization by doing the following: 1. Explain how financial statements are reviewed for an organization to determine its profitability and risk.2. Discuss factors that influence the financial viability of a healthcare organization.
C. Discuss how the financial decision-making process impacts the operations of a healthcare organization.
D. Discuss how each of the following fraud and abuse regulations impact the financial decisions made by a healthcare organization: Stark II Anti-Kickback Statute1. Discuss the importance of Stark II to healthcare providers.2. Discuss the importance of the Anti-Kickback Statute to healthcare providers.
E. Analyze the factors that influence healthcare pricing in healthcare organizations.
F. Discuss the relationship between financial planning and strategic planning.1. Explain how a financial plan is developed.a. Recommend how a HIM manager should interact with the finance department to ensure the efficacy of a financial plan.
G. Explain the financial management control process, including budgeting and financial planning.
H. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
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WGU Performance Assessment
Heat maps
YMM1 YMM1 TASK 1
HEALTHCARE FINANCIAL RESOURCE MANAGEMENT C811
PRFA YMM1
PREPARATION
TASK OVERVIEW
SUBMISSIONS
EVALUATION REPORT
COMPETENCIES
7031.1.1 : Coding, Billing, and Revenue Cycle Processes
The graduate analyzes how coding and billing cycle processes impact institutional revenue cycles.
7031.1.2 : Healthcare Finance
The graduate evaluates ?nancial information, organization classi?cation, and ?nancial decision-making
processes in the operations of healthcare organizations.
7031.1.3 : Operating Revenue and the Revenue Cycle
The graduate analyzes how sources of operating revenue impact the revenue cycle in healthcare
organizations.
7031.1.4 : Legal and Regulatory Environment
The graduate evaluates policies and procedures in healthcare organizations to ensure compliance with
federal laws and regulations.
7031.1.5 : Revenue Determination
The graduate analyzes the general factors that in?uence healthcare pricing in healthcare organizations.
7031.1.6 : General Accounting Principles and Financial Statements
The graduate analyzes ?nancial statements for pro?tability and risk in healthcare organizations.
7031.1.7 : Strategic Financial Planning
The graduate reviews the strategic ?nancial process and ?nancial plans for healthcare organizations.
7031.1.8 : Management Control Process
The graduate analyzes the ?nancial management control processes in healthcare organizations.
INTRODUCTION
Within the healthcare environment there are many factors that need to be considered when examining
organizational ?nances and making ?nancial decisions that will have both short- and long-term effects on an
organization or a medical practice. There are external agencies such as the federal or state government,
which may set rate limits that impact revenues. Also, there are outside forces such as marketing structures
and competition that in?uence pricing of healthcare services. Managers who oversee budgets and help to
make ?nancial decisions need an overall understanding of the forces shaping this environment.
In this task you will examine the steps of the revenue cycle, explain how to evaluate the ?nancial condition of
a healthcare organization, as well as take a closer look at the ?nancial decision-making process, federal fraud
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and abuse regulations, healthcare pricing, the relationship between ?nancial planning and strategic planning,
and the ?nancial management control process.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no
more than a 10% match to any one individual source can be directly quoted or closely paraphrased from
sources, even if cited correctly. The similarity report that is provided when you submit your task can be used
as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that
will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric
aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless
speci?ed in the task requirements. All other submissions must be ?le types that are uploaded and submitted
as attachments (e.g., .docx, .pdf, .ppt).
A. Explain the activities of each step of the revenue cycle in the order they occur.
1. Describe the work of health information management (HIM) staff members during each step of the
revenue cycle in which they would be involved.
2. Explain how coding and billing cycle processes impact healthcare organization revenue cycles.
3. Explain how the operating revenue impacts the revenue cycle.
B. Explain how to evaluate the ?nancial condition of a healthcare organization by doing the following:
1. Explain how ?nancial statements are reviewed for an organization to determine its pro?tability and
risk.
2. Discuss factors that in?uence the ?nancial viability of a healthcare organization.
C. Discuss how the ?nancial decision-making process impacts the operations of a healthcare organization.
D. Discuss how each of the following fraud and abuse regulations impact the ?nancial decisions made by a
healthcare organization:
Stark II
Anti-Kickback Statute
1. Discuss the importance of Stark II to healthcare providers.
2. Discuss the importance of the Anti-Kickback Statute to healthcare providers.
E. Analyze the factors that in?uence healthcare pricing in healthcare organizations.
F. Discuss the relationship between ?nancial planning and strategic planning.
1. Explain how a ?nancial plan is developed.
a. Recommend how a HIM manager should interact with the ?nance department to ensure the
ef?cacy of a ?nancial plan.
G. Explain the ?nancial management control process, including budgeting and ?nancial planning.
H. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or
summarized.
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I. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, csv, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, ?v, asf,
mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
A:REVENUE CYCLE
NOT EVIDENT
COMPETENT
An explanation of the activities
APPROACHING
COMPETENCE
in the revenue cycle is not
The explanation of the activities
includes each step of the revenue
provided.
does not provide 1 or more of
cycle in the order they occur. The
the steps of the revenue cycle,
explanation logically and accu-
or the steps are not in the order
rately addresses the activities of
they occur. Or the explanation
the revenue cycle.
The explanation of the activities
does not logically or accurately
address the activities of the revenue cycle.
A1:HIM WORK
NOT EVIDENT
COMPETENT
A description of the work and in-
APPROACHING
COMPETENCE
volvement of HIM staff mem-
The description of the work or
involvement of HIM staff mem-
bers during the revenue cycle is
involvement of HIM staff mem-
bers during the revenue cycle in-
not provided.
bers during the revenue cycle is
cludes each step. The ideas pre-
missing 1 or more steps. Or the
sented are relevant and well
ideas presented are irrelevant
supported.
The description of the work and
or poorly supported.
A2:CODING AND BILLING CYCLE PROCESSES
NOT EVIDENT
COMPETENT
An explanation of how coding or
APPROACHING
COMPETENCE
billing cycle processes impact
The explanation does not logi-
clearly addresses how the coding
healthcare organization revenue
cally or clearly address how cod-
and billing processes impact
cycles is not provided.
ing or billing processes impact
healthcare organization revenue
healthcare organization revenue
cycles.
The explanation logically and
cycles.
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A3:OPERATING REVENUE
NOT EVIDENT
COMPETENT
An explanation of how the oper-
APPROACHING
COMPETENCE
ating revenue impacts the rev-
The explanation does not logi-
clearly addresses how the oper-
enue cycle is not provided.
cally or clearly address how the
ating revenue impacts the rev-
operating revenue impacts the
enue cycle.
The explanation logically and
revenue cycle.
B1:PROFITABILITY AND RISK
NOT EVIDENT
COMPETENT
An explanation of how ?nancial
APPROACHING
COMPETENCE
statements are reviewed for an
The explanation of how ?nancial
statements are reviewed for an
organization to determine its
statements are reviewed for an
organization to determine its
pro?tability or risk is not
organization to determine its
pro?tability and risk is logical and
provided.
pro?tability or risk is illogical or
well supported.
The explanation of how ?nancial
poorly supported.
B2:FINANCIAL VIABILITY
NOT EVIDENT
COMPETENT
A discussion of factors that in-
APPROACHING
COMPETENCE
?uence the ?nancial viability of
The discussion of the factors
in?uence the ?nancial viability of
a healthcare organization is not
that in?uence the ?nancial via-
a healthcare organization is clear
provided.
bility of a healthcare organiza-
and well supported.
The discussion of the factors that
tion is unclear or poorly
supported.
C:FINANCIAL DECISION-MAKING PROCESS
NOT EVIDENT
COMPETENT
A discussion of how the ?nancial
APPROACHING
COMPETENCE
decision-making process im-
The discussion of how the ?nan-
cial decision-making process im-
pacts the operations of a health-
cial decision-making process im-
pacts the operations of a health-
care organization is not
pacts the operations of a health-
care organization is well rea-
provided.
care organization is poorly rea-
soned and clear.
The discussion of how the ?nan-
soned or unclear.
D:FRAUD AND ABUSE REGULATIONS
NOT EVIDENT
A discussion of how the given
APPROACHING
COMPETENCE
regulations impact the ?nancial
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COMPETENT
The discussion of how each of the
given regulations impacts the ?4/7
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WGU Performance Assessment
decisions made by a healthcare
The discussion of how the given
nancial decisions made by a
organization is not provided.
regulations impact the ?nancial
healthcare organization is well
decisions made by a healthcare
reasoned and well supported.
organization is poorly reasoned
or poorly supported for 1 or
both regulations.
D1:IMPORTANCE OF STARK II
NOT EVIDENT
COMPETENT
A discussion of the importance
APPROACHING
COMPETENCE
of Stark II to healthcare
The discussion of the impor-
of Stark II to healthcare
providers is not provided.
tance of Stark II to healthcare
providers is logical and clear.
The discussion of the importance
providers is not logical or
unclear.
D2:IMPORTANCE OF ANTI-KICKBACK STATUTE
NOT EVIDENT
COMPETENT
A discussion of the importance
APPROACHING
COMPETENCE
of the Anti-Kickback Statute to
The discussion of the impor-
of the Anti-Kickback Statute to
healthcare providers is not
tance of the Anti-Kickback
healthcare providers is logical
provided.
Statute to healthcare providers
and clear.
The discussion of the importance
is not logical or unclear.
E:HEALTHCARE PRICING
NOT EVIDENT
COMPETENT
An analysis of the factors that
APPROACHING
COMPETENCE
in?uence healthcare pricing in
The analysis of the factors in?u-
encing healthcare pricing in
healthcare organizations is not
encing healthcare pricing in
healthcare organizations is logi-
provided.
healthcare organizations is illog-
cal and well supported.
The analysis of the factors in?u-
ical or poorly supported.
F:FINANCIAL AND STRATEGIC PLANNING
NOT EVIDENT
COMPETENT
A discussion of the relationship
APPROACHING
COMPETENCE
between ?nancial planning and
The discussion of the relation-
between ?nancial planning and
strategic planning is not
ship between ?nancial planning
strategic planning is relevant and
provided.
and strategic planning is irrele-
logical.
The discussion of the relationship
vant or illogical.
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F1:FINANCIAL PLAN DEVELOPMENT
NOT EVIDENT
COMPETENT
An explanation of how a ?nan-
APPROACHING
COMPETENCE
cial plan is developed is not
The explanation of how a ?nan-
cial plan is developed is logical
provided.
cial plan is developed is illogical
and well supported.
The explanation of how a ?nan-
or poorly supported.
F1A:HIM INTERACTION
NOT EVIDENT
COMPETENT
A recommendation of how a
APPROACHING
COMPETENCE
HIM manager should interact
The recommendation of how a
HIM manager should interact
with the accounting department
HIM manager should interact
with the accounting department
to ensure the ef?cacy of a ?nan-
with the accounting department
to ensure the ef?cacy of a ?nan-
cial plan is not provided.
to ensure the ef?cacy of a ?nan-
cial plan is well supported and
cial plan is poorly supported or
logical.
The recommendation of how a
illogical.
G:FINANCIAL MANAGEMENT CONTROL PROCESS
NOT EVIDENT
COMPETENT
An explanation of the ?nancial
APPROACHING
COMPETENCE
management control process is
The explanation of the ?nancial
management control process in-
not provided.
management control process
cludes both budgeting and ?nan-
does not include either budget-
cial planning, and the explanation
ing or ?nancial planning, or the
is logical and well supported.
The explanation of the ?nancial
explanation is illogical or poorly
supported.
H:SOURCES
NOT EVIDENT
COMPETENT
The submission does not include
APPROACHING
COMPETENCE
both in-text citations and a ref-
The submission includes in-text
citations for sources that are
erence list for sources that are
citations for sources that are
properly quoted, paraphrased, or
quoted, paraphrased, or
quoted, paraphrased, or summa-
summarized and a reference list
summarized.
rized and a reference list; how-
that accurately identi?es the au-
ever, the citations or reference
thor, date, title, and source loca-
list is incomplete or inaccurate.
tion as available.
The submission includes in-text
I:PROFESSIONAL COMMUNICATION
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NOT EVIDENT
WGU Performance Assessment
COMPETENT
Content is unstructured, is dis-
APPROACHING
COMPETENCE
jointed, or contains pervasive
Content is poorly organized, is
tails, is organized, and focuses on
errors in mechanics, usage, or
dif?cult to follow, or contains er-
the main ideas as prescribed in
grammar. Vocabulary or tone is
rors in mechanics, usage, or
the task or chosen by the candi-
unprofessional or distracts from
grammar that cause confusion.
date. Terminology is pertinent, is
the topic.
Terminology is misused or
used correctly, and effectively
ineffective.
conveys the intended meaning.
Content re?ects attention to de-
Mechanics, usage, and grammar
promote accurate interpretation
and understanding.
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