Follow rubric verbatim
Reading: Principles of Healthcare Reimbursement and Revenue Cycle Management, Chapter 11
Textbook link: https://bncvirtual.com/vb_econtent.php?ACTION=econtent&FVENCKEY=AD9EE8D798DCAFC7E76B5FB7C978DD86&j=43766531&sfmc_sub=1597096465&l=23329524_HTML&u=695880241&mid=524003857&jb=40753&utm_term=10242022&utm_source=transactional&utm_medium=email&utm_campaign=Direct_Ebooks
What to Submit
Submit your analysis report as a 5- to 6-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Sources should be cited according to APA style.
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IHP 630 Module Five Project Preparation Guidelines and Rubric
Overview
In this module, you learned about the signi�cance of staf�ng in healthcare strategic planning initiatives and the revenue cycle. You also looked at the role of leadership to improve team
performance and the areas in the back-end revenue cycle.
To recap, the components in the back-end revenue cycle include (but are not limited to) the following areas:
Claims Production
Claims Submission
Determining Expected Reimbursement
Adjudication
Bene�ts Statements
Claims Reconciliation
Denial Management
In this assignment, you will create an analysis report on the staf�ng system of a healthcare organization based on the identi�ed areas of the back-end process of the revenue cycle.
This assignment will help you describe best practices for revenue-cycle staf�ng models and align staf�ng models with strategic planning initiatives. It will also enable you to demonstrate how
key leadership competencies improve revenue-cycle team performance. From a healthcare management perspective, this activity will help you understand how to set up and manage a robust
staf�ng process. This activity will help you prepare for sections 3 (Staf�ng Impact) and 5B (Work�ow Assessment Findings) in the course project.
Directions
Create an analysis report on the staf�ng requirements in the backend process of a healthcare organization.
If you need writing support, access the Online Writing Center through the Academic Support module of your course.
Speci�cally, you must address the following rubric criteria:
1. Staf�ng Competencies: Describe the staf�ng competencies needed for hiring team members in the back-end revenue cycle. Consider the following questions to guide your response:
What competencies are needed for the back-end processes of the revenue cycle?
What makes this competency speci�c to the healthcare domain?
2. Revenue Integrity: Explain the importance of the back-end processes of the revenue cycle for preserving revenue integrity. Consider the following questions to guide your response:
How do organizations incorporate operational ef�ciency in the back-end processes?
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How is compliance to regulatory requirements built into the back-end processes?
3. Role of Leadership: Explain the role of leadership in ensuring staf�ng competencies. Consider the following questions to guide your response:
What skillsets or knowledge should a leader look for when recruiting somebody for the back-end process?
How would the leader keep the team updated in skillsets and knowledge?
4. Lapses and Prevention: Identify processes to prevent lapses and/or gaps in the staf�ng model. Consider the following questions to guide your response:
What kind of lapses and/or gaps are possible across the entire process?
What are the possible reasons behind these lapses and/or gaps?
5. Impact of Failure: Discuss the impact of any failure in the claims production and claims submission areas of the revenue cycle. Consider the following questions to guide your response:
What are some of the possible events of failure that could happen in the �rst two areas?
Who would be impacted by such events?
6. Financial Impact of Declined Claims: Discuss the �nancial impact of initially declined claims and delayed payments to healthcare organizations. Consider the following questions to guide
your response:
Do healthcare organizations face the same �nancial impact for governmental and private insurance claims?
What steps can be taken by the back-end processes staff and by leadership to ensure these delays do not happen?
All the claims in your deliverable should be evidence based. Your citations should be from your independent search for evidence (not from the textbook, or module resources) of credible
sources and be current within the last �ve years. You are required to cite between 3-5 resources, with a minimum of three sources, at least one which is not also one of your Project One
resources. Refer to the IHP 630 Library Guide located in the Start Here section of the course for additional support.
What to Submit
Submit your analysis report as a 5- to 6-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Sources should be cited according to APA
style.
Module Five Project Preparation Rubric
Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value
Staf�ng Competencies Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Describes the staf�ng
competencies needed for hiring
team members in the back-end
revenue cycle
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 10
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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value
Revenue Integrity Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Explains the importance of the
back-end processes of the
revenue cycle for preserving
revenue integrity
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 10
Role of Leadership Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Explains the role of leadership
in ensuring staf�ng
competencies
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 10
Lapses and Prevention Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Identi�es processes to prevent
lapses and/or gaps in the
staf�ng model
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Impact of Failure Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Discusses the impact of any
failure in the claims production
and claims submission areas of
the revenue cycle
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Financial Impact of Declined
Claims
Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Discusses the �nancial impact
of initially declined claims and
delayed payments to
healthcare organizations
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Articulation of Response Exceeds pro�ciency in an
exceptionally clear and
insightful manner
Clearly conveys meaning with
correct grammar, sentence
structure, and spelling,
demonstrating an
understanding of audience and
purpose
Shows progress toward
pro�ciency, but with errors in
grammar, sentence structure,
and spelling, negatively
impacting readability
Submission has critical errors in
grammar, sentence structure,
and spelling, preventing
understanding of ideas
10
Scholarly and Professional
Sources
Incorporates more than two
scholarly, current (within the
last �ve years) sources, or use
of sources is exceptionally
insightful
Incorporates two scholarly,
current (within the last �ve
years) sources that support
claims
Incorporates fewer than two
scholarly, current (within the
last �ve years) sources, or not
all sources support claims
Does not incorporate sources 10
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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value
APA Style Formats in-text citations and
reference list according to APA
style with no errors
Formats in-text citations and
reference list according to APA
style with fewer than �ve
errors
Formats in-text citations and
reference list according to APA
style with �ve or more errors
Does not format in-text
citations and reference list
according to APA style
5
Total: 100%