MVCC Impact of Hipaa Transaction and Code Set Standards Discussion
Question Description
A. Analyze the quality reporting systems sponsored by Centers for Medicare and Medicaid Services (CMS) by doing the following:
1. Discuss the goals of the Merit-based Incentive Payment System (MIPS).
a. Describe the advantages and disadvantages of the MIPS.
2. Discuss the goals of the Value-Based Purchasing System (VBPS).
a. Describe the advantages and disadvantages of the VBPS.
3. Describe the role of Health Informatics and Information Management (HIIM) staff in participating in both MIPS and VBPS.
B. Explain the role of Quality Improvement Organizations (QIOs) contracted under CMS as it applies to the reimbursement process.
C. Describe the impact of HIPAA Transaction and Code Set standards on the reimbursement process.
1. Discuss the impact of Code Set Standards on coders.
D. Discuss the impact of the EHR Regulatory Relief Act on healthcare reimbursements.
E. Discuss how emerging technology is evaluated in the reimbursement process.
1. Explain how emerging technology will impact the future of reimbursement.
F. Discuss current or emerging technology that healthcare organizations use to minimize fraud and abuse. Include the following details in your discussion:
features
system requirements
security features
remote access
interoperability
G. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
RUBRIC
NOT EVIDENT A discussion is not provided. |
APPROACHING COMPETENCE The discussion of the MIPS contains some inaccuracies about the systems goals. |
COMPETENT The discussion accurately addresses the goals of the MIPS. |
A1A. MIPS: ADVANTAGES AND DISADVANTAGES:
NOT EVIDENT A description is not provided. |
APPROACHING COMPETENCE The description does not accurately describe the advantages and disadvantages of the MIPS. |
COMPETENT The description accurately describes both the advantages and disadvantages of the MIPS. |
NOT EVIDENT A discussion is not provided. |
APPROACHING COMPETENCE The discussion does not accurately describe the goals of the VBPS. |
COMPETENT The discussion accurately addresses the goals of the VBPS. |
A2A. VBPS: ADVANTAGES AND DISADVANTAGES:
NOT EVIDENT A description is not provided. |
APPROACHING COMPETENCE The description does not accurately describe the advantages and disadvantages of the VBPS. |
COMPETENT The description accurately describes the advantages and disadvantages of the VBPS program. |
NOT EVIDENT A description is not provided. |
APPROACHING COMPETENCE The description is illogical or does not describe the role of HIIM professionals in MIPS and VBPS |
COMPETENT The description is logical and describes the role of HIIM professionals in participating in both MIPS and VBPS. |
B. QUALITY IMPROVEMENT ORGANIZATIONS:
NOT EVIDENT An explanation is not provided. |
APPROACHING COMPETENCE The explanation is illogical, does not explain the role of QIOs contracted under CMS, or does not explain the relevance to the reimbursement process. |
COMPETENT The explanation is logical and explains the role of QIOs contracted under CMS and explains the relevance to the reimbursement process. |
C. HIPAA TRANSACTION AND CODE SET STANDARDS:
NOT EVIDENT A description is not provided. |
APPROACHING COMPETENCE The description is illogical or inaccurately describes the impact of the HIPAA Transaction and Code Set standards on the reimbursement process. |
COMPETENT The description is logical and accurately describes the impact of the HIPAA Transaction and Code Set standards on the reimbursement process. |
NOT EVIDENT A discussion is not provided. |
APPROACHING COMPETENCE The discussion does not accurately discuss the impact of the Code Set Standards on coders,. |
COMPETENT The discussion accurately details the impact of the Code Set Standards on coders. |
NOT EVIDENT A discussion is not provided. |
APPROACHING COMPETENCE The discussion does not accurately discuss the impact of the EHR Regulatory Relief Act on healthcare reimbursements. |
COMPETENT The discussion accurately discusses the impact of the EHR Regulatory Relief Act on healthcare reimbursements. |
E. EMERGING TECHNOLOGY IN REIMBURSEMENT:
NOT EVIDENT A discussion is not provided. |
APPROACHING COMPETENCE The discussion is illogical regarding how emerging technology is evaluated in the reimbursement process. |
COMPETENT The discussion is logical and discusses how emerging technology is evaluated in the reimbursement process. |
NOT EVIDENT An explanation is not provided. |
APPROACHING COMPETENCE The explanation does not logically explain how emerging technology will impact the future of reimbursement or the explanation is poorly supported. |
COMPETENT The explanation logically explains how emerging technology will impact the future of reimbursement and the explanation is well supported. |
NOT EVIDENT A discussion is not provided. |
APPROACHING COMPETENCE The discussion does not logically discuss a current or emerging technology that healthcare organizations use to minimize fraud and abuse or the discussion does not include each of the given points and how they are relevant to minimizing fraud. |
COMPETENT The discussion logically discusses a current or emerging technology that healthcare organizations use to minimize fraud and abuse. The discussion includes each the given points and how they are relevant to minimizing fraud. |
NOT EVIDENT The submission does not include in-text citations and references according to APA style for content that is quoted, paraphrased, or summarized. |
APPROACHING COMPETENCE The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized but does not demonstrate a consistent application of APA style. |
COMPETENT The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style. |
NOT EVIDENT Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic. |
APPROACHING COMPETENCE Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective. |
COMPETENT Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding. |
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