AMU Medicare Discussion Assignment

Respond back to these 4 responses: 1. Medicare and Medicaid are the most popular health insurance programs run by the federal government. Medicare is a social insurance program that funds hospital and medical care for older people. It also consists of parts A, B, C, and D. A and B cover hospital and medical insurance, and C and D provide flexibility and prescription drugs (Galan, 2020). Medicaid is targeted toward low-income households with minimal resources and requires specific requirements to qualify. The state also dictates these requirements but is overseen by federal authorities (Galan, 2020). Similarities between both include creation by the U.S government, funded by taxpayers, and they can both cover healthcare service expenses. The major difference between them is the target population. Medicare focuses on the elderly while Medicaid focuses on low-income households with no specific age requirement (Radhakrishnan, 2022).

The difference between Medicaid/Medicare and Voluntary Health Insurance (VHI) stems from the mode of production. Medicare/Medicaid is a government program while organizations offer VHI to their employees. There is also more flexibility with VHI when compared to Medicare/Medicaid (De Pietro, 2021). 2.Good Afternoon Professor and Classmates,  AMU Medicare Discussion Assignment

Medicare and Medicaid are two different healthcare insurance plans that have many similarities as well as differences. Let’s start by establishing how they are different. Medicare derived from the Social Security Act which was amended on July 30, 1965. It is mainly for elderly patients exactly 65 years or older. You are also eligible if you are entitled to social security benefits for a minimum of 24 months, a government employee disabled for 29 months, or an insured worker with end-stage renal disease. There are four parts to the Medicare plan which are A through D. Part A is for inpatient hospitalization, including hospice care, long-term care, and nursing facilities. Part B is optional supplemental medical insurance and will add monthly premiums, an annual deductible, and co-payments to your expenses. Part C is also an optional service that covers dental, vision, and hearing aids. Part D covers prescription drugs.

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On the other hand, Medicaid was also added as a part of the Social Security Act in 1965. Unlike Medicare, Medicaid is a joint insurance program administered by state and local governments. Depending on what state you are in determines what services are offered. Each state has their own eligibility requirements. Medicaid serves low-income people and families of every age, unlike Medicare. Medicaid has guidelines and required services to include inpatient, outpatient, medical and surgical dental, lab, and x-ray.

I was under my mother’s insurance until I joined the military. She has Blue Cross Blue Shield which is an voluntary insurance plan. I remember getting an MRI of my knee, which I know is one of the many services offered by Medicare and Medicaid. Blue Cross Blue Shield contracts with various providers to provide service to subscribers. 3. Ethical issues exist in every career, regardless of title, but especially in healthcare. The ethical concerns in Health Information Management and learning how to deal with them are critical. The most common ethical issues resolve around the coding reimbursement link, quality review, information security, data resource management, sensitive information protection, drug and alcohol misuse, mental health, and sexual abuse information. Health information management (HIM) is a job devoted to keeping patients records secure and private, and such work necessities a strong sense of ethics. It is critical for a HIM professional to understand and apply their code of ethics in all that they do. HIPPA compliance includes access to information release and documentation standard. Fore example, you cannot simply information to someone because they claim to be a family of the patient; certain processes must be taken to validate the transfer of information. Another potential ethical difficulty is vendors demanding for payment for services not rendered or third parties requesting unauthorized access to information such as genetic information, adoption information, or behavioral health information.

As a health information manager, I would address these issues by serving as a role model, advocating ethical behavior, and monitoring employee behavior. I would also deal with issues by leading by example and facing workplace problems in an ethical manner, letting colleagues know that the future problems will be addressed in the same manner. It would be critical for me as a manager to understand the policies and procedures so that I could support and enforce them with the staff, so improving ethical behavior. I would also use the steps to ethical decision making, which are clearly defining the issue, determining the facts of the situation, determining who the stakeholders are, the values at stake, and the obligations and interests of each stakeholder, deciding what should be done, justifying the decision made by identifying reasons that support the decision, implementing the decision, evaluating the decision’s outcome, and examining the decision. 4. This week are to discuss what some of the most frequent ethical challenges are in health information management. Some ethical challenges that come to mind are protecting patient information properly. Even though I would hope that every medical facility has a secure server or data storage area, mistakes happen. Billing would be another one that seems to be a big one. Trying to bill correctly is super important but sometimes people get carried away. Keeping patient information confidential is one that sometimes becomes a challenge. Keeping patients safety a priority and not cutting corners is another challenge that some may come across. AMU Medicare Discussion Assignment

If I was a health information manager I would try and have everyone trained on HIPAA and make sure they know how serious it is to make sure everyone’s information, personal and health related is taken seriously. I would also make sure the billing is being done correctly. I would go over in training how important it is not to cut corners on supplies just to save. Quality items will save time and keep our patients safe. I would also just make sure that everyone in the office is acting appropriately and not talking about or sharing information with one another that is not valid to the task at hand. If you are not working on something for the patient, then you should not be talking about their situation.