Instructions: Research and summarize two articles pertaining to this week’s topics. Submission Instructions: Describe the issues and topics using research outside the textbook. The financial and operational aspects of an organization are important. Health care administrators must have a basic understanding of these areas to successfully run their respective departments and/or organizations. We will look at how departments structure key financial positions within their respective HCOs and how duties and responsibilities are delegated and managed. APA formatted, describing the critical areas of research. Journal and/or peer-reviewed articles required. Industry terminology must be used. Current research within the last five years is preferred. Health insurance and reimbursement methodologies are foundational to understanding health care finance. Health care administrators must have a basic understanding of these areas to successfully run their respective departments and/or organizations. Interestingly, most consumers have no concept of how their benefits are designed, implemented, and paid for. Understanding health insurance from a financial perspective is one aspect to review. Aligning insurance with networks, co-pays, co-insurance, and deductibles from a structural perspective, and connecting the dots with providers and payors, complicates matters even further. Hopefully, this section will clarify these complexities. At the end of this module, students will be able to: Review the history of setting charges. (CO1, CO4) Define the various methods of setting charges. (CO2, CO4) Describe the impact of cost shifting. (CO1) Review methods of reimbursement to providers. (CO1, CO4)
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