RULES AND REGULATIONS TO HEALTH CARE

Write 400 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas. 

For this assignment, you will review the Health Information Portability and Accountability Act (HIPAA) policies and regulations. HIPAA is a series of government regulations defining private, confidential medical information. These regulations dictate who can use and transmit medical information. The clinic policy states that you are required to explain the HIPAA policy to the patient, obtain his or her signature after you answer any questions, and give a copy of the document to the patient.

Discuss the following:

· What are the rules and regulations that pertain to the health care organizations? 

· Should there be mandatory training on HIPAA rules and regulations and a competency test? Why, or why not? 

Project 2 DUE 3/14

Draft (Project 3 is the Final Draft)

In this assignment, you will develop a training manual that will be utilized for training new employees (certified medical administrative assistants [CMAAs]) who join the clinic. 8 pages; APA format RULES AND REGULATIONS TO HEALTH CARE. 

Physicians are hiring more CMAAs to help manage the increasing complexities of patient care and practice management, while also helping to implement cost-effectiveness and efficiency. The responsibilities of a CMAA can be tailored to the needs of the practice. You will manage front-office functions, manage patient flow, and handle a wide range of tasks that have been discussed in the past few weeks. As a CMAA, you may convey clinical information on behalf of the physician and follow clinical protocol when speaking with patients, but you cannot exercise independent medical judgments. You will also help to optimize patient flow, enabling the physician to see more patients with efficiency, all while following your State’s scope of practice and working under the supervision of a licensed physician.

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The project deliverables are as follows:

· Training Manual 

o Title page 

§ Course number and name

§ Project name

§ Your name

§ Date 

o The training manual should include the following topics: 

§ An introduction to the health care system

§ The organization’s structure

§ The process of checking patients in and out

§ Scheduling patients

§ Various community and patient resources

§ Processes for how to interact with patients

§ Health insurance plans

§ Financial procedures related to the policies of the organization

§ Clean claims

§ Financial procedures related to the organization’s cash flow

§ Billing policy and procedures

§ Protecting patients’ privacy

§ Accounting and bookkeeping procedures and processes

§ Office procedures for various forms of documentation (release of information, electronic health record)

§ Health Insurance Portability and Accountability Act (HIPAA) rules and regulations RULES AND REGULATIONS TO HEALTH CARE

§ HIPAA forms

§ Advance directives

§ Medical record responsibilities

§ Obtaining patient demographics and insurance information

§ Receive, triage, and route phone calls

§ Review records for medical necessity

§ Release of information guidelines 

Project 3 FINAL PROJECT DUE 3/16

This final draft represents Part 1 and Part 2 of the Key Assignment. You should treat it as a finished document in terms of grammar, formatting, references, all necessary sections, and complete content. 

Training Manual

In this assignment, you will develop a training manual that will be utilized for training new employees (certified medical administrative assistants [CMAAs]) who join the clinic.

Physicians are hiring more CMAAs to help manage the increasing complexities of patient care and practice management, while also helping to implement cost-effectiveness and efficiency. Your responsibilities as a CMAA can be tailored to the needs of the practice. You will manage front-office functions, manage patient flow, and handle a wide range of tasks that have been discussed in the past few weeks. As a CMAA, you may convey clinical information on behalf of the physician and follow clinical protocol when speaking with patients, but you cannot exercise independent medical judgments. You will also help to optimize patient flow, enabling the physician to see more patients with efficiency, all while following your State’s scope of practice and working under the supervision of a licensed physician RULES AND REGULATIONS TO HEALTH CARE. 

Add a final section to your training manual that will be utilized for training new employees (CMAAs) who join the clinic.

As a CMAA in a clinic, you are responsible for ensuring that job performance is in compliance with regulatory agency guidelines. There are many areas of compliance that a CMAA must be familiar with: financial risk, local and state regulations, Occupational Safety and Health Administration (OSHA), transmission and release of information, HIPAA guidelines, patient care procedures, and prevention of medical errors. For this part of the assignment, you will add the following topics to your training manual:

· Identify and discuss 3 compliance risks. 

· Indicate the consequences of not meeting these requirements. 

Add a conclusion that should include the guidelines or policies that should have been followed to prevent this infraction RULES AND REGULATIONS TO HEALTH CARE.

ADAPTIVE RESPONSE

Consider the following scenarios:

Scenario 1: Jennifer is a 2­year­old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days.  Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2­year­old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute ADAPTIVE RESPONSE.

Scenario 2: Jack is a 27­year­old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished ADAPTIVE RESPONSE.

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Scenario 3: Martha is a 65­year­old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with

hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87­year­old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To prepare:

Review the three scenarios, as well as Chapter 6 in the Huether and McCance text. Identify the pathophysiology of the disorders presented in the scenarios, including their associated alterations. Consider the adaptive responses to the alterations. Review the “Mind Maps—Dementia, Endocarditis, and Gastro­oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations ADAPTIVE RESPONSE.

To complete:

Write a 2­ to 3­page paper that addresses the following:

Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations. Construct a mind map of your selected disorder. Include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting ADAPTIVE RESPONSE.

REPORT ON PATHO

Consider the following scenarios:

Scenario 1:
Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days.  Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute REPORT ON PATHO.

Scenario 2:
Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished REPORT ON PATHO.

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Scenario 3:
Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To prepare:

• Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.
• Identify the pathophysiology of the disorders presented in the scenarios, including their associated alterations. Consider the adaptive responses to the alterations.
• Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations REPORT ON PATHO.

To complete:

Write a 2- to 3-page paper that addresses the following:

• Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations.
• Construct a mind map of your selected disorder. Include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations REPORT ON PATHO.

REPORT ON HYPERTENSION
In clinical settings, advanced practice nurses frequently use various strategies to treat and manage patients with hypertension and other cardiovascular disorders. These strategies often include pharmacologic and nonpharmacologic therapies, natural remedies, and/or changes in patient behavior. For hypertension patients, behavioral changes including increased exercise, healthier diet, and smoking cessation have proven to be particularly beneficial. However, it is important to recognize that treatment and management plans centered around changes in behavior often require greater patient commitment. This creates the need for patient-provider collaboration, as well as appropriate patient education. When patients are actively involved in their own care and better understand implications of their disorders, they are more likely to adhere to treatment plans REPORT ON HYPERTENSION.

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To prepare:

•Review Part 11 of the Buttaro et al. text and the National Heart Lung Blood Institute article in this week’s Learning Resources.

•Reflect on your Practicum Experiences and observations. Select a case from these experiences that involves a patient who presented with a hypertension problem. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

•Think about the patient’s history including drug treatments and behavioral factors such as diet, exercise, smoking, etc.

•Review the National Heart Lung Blood Institute article in the Learning Resources. Reflect on health promotion strategies for the patient. Consider ways to reinforce hypertension management.

Post  1 to 2 pages on : Choose your own patient and a description of a patient who presented with a hypertension problem during your Practice as a nurse practitioner  Experience. Explain the patient’s history including drug treatments and behavioral factors. Then, suggest two health promotion strategies for the patient. Include suggestions for reinforcing hypertension management.

REFERENCE/RESOUECES

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.

 ◦Part 11, “Evaluation and Management of Cardiovascular Disorders” (pp. 487–611)

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Mosby.

 ◦Chapter 26, “Recording Information

National Heart Lung and Blood Institute. (2002). Primary prevention of hypertension: Clinical and public health advisory from the National High Blood Pressure Education Program. Retrieved from http://www.nhlbi.nih.gov/files/docs/resources/heart/pphbp.pdf

American Heart Association. (n.d.). Retrieved November 28, 2012, from http://www.heart.org/HEARTORG REPORT ON HYPERTENSION.