HI 215 Hospital Outpatient Prospective Payment System Discussion
HI 215 Hospital Outpatient Prospective Payment System Discussion
HI 215 Hospital Outpatient Prospective Payment System Discussion
Hospital Outpatient Prospective Payment System
Instructions: Review the , Case 2 “Claims Management” answering the case specific questions below for each.
- What should WPS do with CMS to improve the process?
- As an executive for the Wisconsin Physicians Service (WPS) Insurance Corporation, after reviewing the case, write a response letter that addresses the issues.
- Include 3 recommendations, with supporting rationale, of how to improve the processes in your response.
Assignment Requirements
- Please complete all parts in a Microsoft Word document.
- Quoting should be less than 10% of the entire paper. Paraphrasing is necessary.
- You must cite and reference credible sources.
- Utilize the Academic Success Center in Academic Tools for assistance with writing, APA style references, etc.
Unit 1 Assignment Rubric Criterion Criterion 1 Criterion 1: Response Letter ● Level III Level II Level I Not Present Level III Max Points Points: 10 Level II Max Points Points: 8 Level I Max Points Points: 6 Not Present 0 points Response letter is written in professional manner, ● Response letter is written in a professional tone with 2-3 missing elements. ● Criterion 2 Level III Max Points Points: 15 Level II Max Points Points: 12 Criterion 2: ● Recommendation s 3 recommendations are ● delivered within the response letter 2 recommendations are delivered in the response letter Criterion 3 Level III Max Points Points: 15 Level II Max Points Points: 12 Detail which support 3 ● recommendations is present and aligned with financial process in the case Detail which support 2 ● recommendations is present and aligned with financial process in the case Level III Max Points Points: 7.5 Level II Max Points Points: 6 Criterion 3: Supporting rationale for recommendation Criterion 4 ● Response letter is ● informal and is missing elements of professional correspondence. Level I Max Points Points: 9 ● 1 recommendation is delivered in the response letter Not Present 0 points ● Level I Max Points Points: 9 Detail which support 1 ● recommendations is present and aligned with financial process in the case Level I Max Points Points: 4.5 Writing is not in the required professional letter format. Writing is missing accurate recommendations were provided in the response letter Not Present 0 points Rationale is not present , inaccurate, or lacks adequate detail throughout. Not Present 0 points Criterion Criterion 4: Grammar & Mechanics Level III ● Criterion 5 The writing is essentially error free in terms of spelling and grammar Level II ● Level III Max Points Points: 2.5 Level I The writing holds less than 10 spelling and grammar errors The writing holds 10-15 spelling and grammar errors Level II Max Points Points: 2 ● Level I Max Points Points: 1.5 ● Maximum Total Points 50 40 30 0 Minimum Total Points 41 31 1 0 Includes reference with minor APA formatting errors ● Includes reference without APA format The writing holds more than 15 spelling and grammar errors Not Present 0 points Criterion 5: APA formatted reference Incudes APA formatted reference ● Not Present ● No reference included …
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