Adequately Explains the chargemaster and claims management applications and process

Instructions
Assignment Instructions
Prepare a revenue cycle plan for a community hospital. Include the following information in your plan:
Introduction
Evaluation of clinical data required for payment and reimbursement systems (PPS, DRG, RBRVS, RUGs, VBP, Billing/insurance plans).
Explanation of chargemaster and claims management applications and processes.
Assess the effect on healthcare finance of revenue management (cost reporting, budget variances).
Summarize revenue cycle management and reporting processes (CCI, X12N).
Evaluation of the severity of illness and how it impacts the healthcare payment systems.
The format of this plan is like a policy and procedure but is a longer document. Compile your document based on the findings and collection of information for each of the requirements
This table lists criteria and criteria group names in the first column. The first row lists level names and includes scores if the rubric uses a numeric scoring method. You can give feedback on each criterion by tabbing to the add feedback buttons in the table.
Criteria
Exemplary
Accomplished
Developing
Beginning
Did Not Attempt
Criterion Score
Evaluation of required clinical data
15 points
Very clear that the relevant topics and information were understood. Demonstrates an impressive command of the subject matter in the assignment. Thoroughly evaluates the required clinical data needed for payment and reimbursement systems. Assignment shows an extraordinary level of depth in the student’s ability to relate course content with practical examples and applications. Student provides a comprehensive analysis of details, facts, and concepts in a logical sequence.
12.75 points
Somewhat clear that the relevant information was understood. Demonstrates proficient command of the subject matter in the assignment. Adequately evaluates the required clinical data needed for payment and reimbursement systems. Assignment provides above average ability in relating course content with example. Student provides details and facts presented provide an adequate representation of student’s current level of subject matter knowledge.
11.25 points
Somewhat unclear that relevant information was understood. Evaluates the required clinical data needed for payment and reimbursement systems but with limited supporting details and examples. Generally explains concepts, but only meets the minimum requirements in this area.
9.75 points
Assignment is incomplete and/or very unclear that relevant information was understood. Student tries to explain and evaluates the required clinical data needed for payment and reimbursement systems, but overlooks critical details. Assignment is very vague, details are unclear. Provides concepts in isolation, and does not perceive to have a logical sequencing of ideas.
0 points
Did not attempt
Score of Evaluation of required clinical data,/ 15
Chargemaster and claims management
15 points
Very clear, relevant information and topics were understood. Demonstrates an impressive a defined and clear understanding of the assignment. Thoroughly explains the chargemaster and claims management applications and process. Shows an impressive level of depth of student’s ability to relate course content to practical examples and applications. Provides comprehensive analysis of details, facts, and concepts in a logical sequence.
12.75 points
Somewhat clear that the relevant information was understood. Demonstrates proficient command of the subject matter in the assignment. Adequately Explains the chargemaster and claims management applications and process. Details and facts presented include supporting statements helping to provide the key focus of the assignment.
11.25 points
Somewhat unclear that relevant information was understood. Provide a basic explanation of the chargemaster and claims management applications and process but with limited details not fully supported throughout the assignment. Very few supporting facts and statements, this has limited the quality of the assignment.
9.75 points
Assignment is incomplete and/or student tries to explains the chargemaster and claims management applications and process, but with limited supporting ideas and examples. Understanding of assignment is not evident; writing is weak in the inclusion of supporting facts or statements.
0 points
Did not attempt
Score of Chargemaster and claims management,/ 15
Evaluate healthcare finance and revenue management
15 points
Very clear, relevant information and topics were understood. Thoroughly evaluates the effect of healthcare finance on revenue management. Provides comprehensive analysis of details, facts, and concepts including cost reporting and budget variances includes exceptional supporting facts, figures, and/or statements.
12.75 points
Assignment establishes a good comprehension of topic and in the building of the assignment. Evaluates the effect of healthcare finance on revenue management. Includes details and examples on cost reporting and budget variances. Demonstrates an effective written presentation with most support statements helping to support the key focus of assignment.
11.25 points
Assignment exhibits a basic understanding of the intended assignment. Explains the effect of healthcare finance on revenue management. Provides some details on cost reporting and budget variances but ideas and examples not fully supported throughout the assignment. While student has included a few supporting facts and statements, this has limited the quality of the assignment.
9.75 points
Assignment is incomplete and/or student tries to explain the effect of healthcare finance on revenue management but examples and details are not well supported. Understanding of assignment is not evident; writing is weak in the inclusion of supporting facts or statements.
0 points
Did not attempt
Score of Evaluate healthcare finance and revenue management,/ 15
Summary of revenue cycle management and reporting processes
20 points
Very clear that the relevant information was understood. Demonstrates advance command of the subject matter in the assignment .Summarizes revenue cycle management and reporting processes (including CCI, X12N) Topic is clearly defined and well constructed with exceptional supporting facts, figures, and/or statements.
17 points
Somewhat clear that the relevant information was understood. Demonstrates proficient command of the subject matter in the assignment. Summarizes revenue cycle management and reporting processes (including CCI, X12N). Provides supporting statements and examples. Assignment demonstrates the student’s above average use and ability of relating concepts by using a variety of factors
15 points
Somewhat unclear that relevant information was understood. Summarizes the revenue cycle management and reporting processes (including CCI, X12N) but with a limited perspective on key concepts throughout assignment.
13 points
Assignment is incomplete and/or very unclear that relevant information was understood. Student tries to explain revenue cycle management and reporting processes (including CCI, X12N) but overlooks critical details and unable to apply information in a problem-solving fashion. Student presents confusing statements and facts in assignment.
0 points
Did not attempt
Score of Summary of revenue cycle management and reporting processes,/ 20
Impact of Severity of Illness on healthcare
15 points
Very clear that the relevant information was understood. Demonstrates advance command of the subject matter in the assignment. Thoroughly evaluates severity of illness and describes the impact on the healthcare payment system. Student shows an impressive level of depth of student’s ability to relate course content to practical examples and applications. Provides comprehensive analysis of details, facts, and concepts in a logical sequence.
12.75 points
Somewhat clear that the relevant information was understood. Demonstrates proficient command of the subject matter in the assignment. Evaluates the severity of illness and describes the impact on the healthcare payment system. Student provides above average ability in relating course content in examples given. Details and facts presented provide an adequate representation of student’s current level of subject matter knowledge.
11.25 points
Somewhat unclear that relevant information was understood. Evaluates severity of illness and describes the impact on the healthcare payment system but with limited supporting details and examples. Generally explains concepts, but only meets the minimum requirements in this area.
9.75 points
Assignment is incomplete and/or very unclear that relevant information was understood. Student tries to explain and evaluates severity of illness and describes the impact on the healthcare payment system but overlooks critical details. Evaluation is vague, details are unclear. Provides concepts in isolation, and does not perceive to have a logical sequencing of ideas.
0 points
Did not attempt
Score of Impact of Severity of Illness on healthcare,/ 15
WRITING SKILL
10 points
Demonstrates an excellent command of grammar, as well as presents research in a clear and concise writing style. Presents a thorough, extensive understanding of word usage. Student excels in the selection and development of a well-planned assignment that is error-free and reflects student’s ability to prepare undergraduate work with no errors in citations.
8.5 points
Provides an effective display of good writing and grammar. Assignment reflects student’s ability to select appropriate word usage and presents an above-average presentation of a given topic or issue. Assignment appears to be well written with no more than 1-2 grammatical errors. Student provides a good final product that covers the above-minimal requirements.
7.5 points
Assignment reflects basic writing and grammar, but with more than 5 grammatical errors. Key terms and concepts are somewhat vague and not completely explained. Student uses a basic vocabulary in assignment. Student’s writing ability is average, but demonstrates a basic understanding of the subject matter.
6.5 points
Topics, concepts, and ideas are not coherently discussed or expressed in assignments. Student’s writing style is weak and needs improvement, along with numerous proofreading and grammatical errors. Assignment lacks clarity, consistency, and correctness..
0 points
Did not attempt
Score of WRITING SKILL,/ 10
ORGANIZATION OF IDEAS/FORMAT
10 points
Policy and Procedure formatted correctly include all content, and well organized.
8.5 points
Policy and Procedure formatted mostly correct with most content, and was well organized.
7.5 points
Policy and Procedure formatted somewhat correctly with some content, but is lacking consistency throughout the paper.
6.5 points
Policy and Procedure not formatted correctly and contains very little content and consistency.
0 points
Did not attempt
Score of ORGANIZATION OF IDEAS/FORMAT,/ 10
Rubric Total Score
Total
Score of HIMA240 Revenue Cycle Plan Rubric,/ 100Criterion score has been overridden
Overall Score
Overall Score
Exemplary
90 points minimum
Accomplished
80 points minimum
Developing
70 points minimum
Beginning
60 points minimum
Did Not Attempt
0 points minimum

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