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Healthcare reimbursement methodologies differ based on the type of service provided, the location the service is provided, and the type of provider. Write a 4-5-page paper that evaluates the types of regulatory requirements, policies, procedures, and audit mechanisms that must be in place for organizations and/or providers to ensure compliance with regulations and that they receive proper reimbursement for the type of service they provide. Select at a minimum 3 of the following methodologies to research for your paper:
Fee-for-Service
Value-based purchasing
Capitation
Global payment
Prospective Payment
Your paper should include examples of non-compliance with regulatory requirements for each methodology and an explanation of the penalties they are subject to. Also, include the role HIM professionals can play in this process.
Your paper should follow APA formatting and be submitted in a Microsoft Word document. See APA formatting instructions posted in the Course Resources Module.
A cover page and works cited page must be included in addition to the 4-5 page paper; however, an abstract page is not required. You are required to use at least 3 peer-reviewed journal articles and/or websites. Reputable websites end in .gov or .org. (AHIMA, CMS, OIG, AHA, AMA, etc. do not use an advertisement page, vendor marketing page, Wikipedia, or blog page).
When your paper is first submitted in Canvas, it will run through Turnitin to detect plagiarism. Any paper indicating more than 25% plagiarism will receive a zero.
