help with peer (6)replies 20 hours
Regulatory Compliance
· Ask at least one question in response to an original peer post that you would like the author to explore further.
· Support your initial and subsequent posts by citing at least two academic resources
Please respond to at least two of your classmates by Day 7 with your responses being approximately 75-100 words in length.
AUDREY POST:
Compliance Programs
If I was the president and CEO of a behavioral health organization two activities that I would choose to focus on for quality and performance improvement are the verification of the qualifications, credentials, and exclusion status of clinicians whose services are reimbursed by federally funded health care programs and ensuring strict adherence to federal and state requirements for informed consent in the provision of BMHS, including psychotropic medication management services (Nguyen, 2010). Making sure that clinicians are qualified and have good credentials will ensure quality care of my patients and in turn we, as an organization, will be able to provide them with the best help for their behavioral health needs. Also, informing a patient of their care, as well as coordinating with the clinician or physician, is important because it is important that a patient understands their care and trusts the clinician or physician and excellent communication can build both understanding and trust(American Psychological Association, 2013).
I would implement these procedures by having a staff meeting and being clear as to what these two procedures mean and what will happen if we do not adhere to them. I would also be very specific in what they mean exactly with examples of how to follow the procedures and how not to follow them so that everyone understands them. I would make sure that everyone has a copy of the rules to ensure that they have something to look back on just in case they forget. I would be very clear that these procedures need to be followed and that it is important for our organization and patients to follow these procedures. Then I would regularly check in with my staff to make sure that the procedures are being followed and that we as an organization are doing the best we can to provide quality care to our patients.
References
American Psychological Association. (2013). HIPAA: What You Need to Know. The Privacy Rule: A
Primer for Psychologists. http://www.apapracticecentral.org/business/hipaa/hipaa-privacy-primer.pdf (Links to an external site.)
Nguyen, D. (2010). The health care reform bill: Compliance implications for behavioral and mental
health services. Journal of Health Care Compliance, 12(4), 11-14, 61.
http://proquest.umi.com/pqdweb?did=2085893211&sid=1&Fmt=3&clientId=101586&RQT=309&VName=PQD
CARMEN’S POST:
Regulatory Compliance
I really enjoyed this week's reading as it teaches us about best practice and keeping in compliance with the state requirements. Nguyen focused on ways to stay in compliance by having quality of services and assessing programs for performance improvement. Two of the integration activities that Nguyen spoke that as a CEO I would address are:
· Verification of the qualifications, credentials, and exclusion status of clinicians whose services are reimbursed by federally funded health care programs, and,
· Improving clinical documentation practices.
These are very important factors in the organization in which I work called CTSHealth. The first activity is essential as the qualifications of the staff must be verified for several reasons. 1) For billing services each credential is paid differently. It is important to understand each credential that is appropriate for your services. For an CMHC in illinois we can hire the following:
Rehabilitative Services Associate (RSA) - Must be 21 years or older, High School diploma or GED, With less than 3 years of experience. Mental Health Professional (MHP) is an individual 21 years or older with a Bachelors in Science minimum, 5+ years in mental health. A Qualified Mental Health Professional (QMHP) is an individual who has a Masters in Science. Lastly a LPCP, LCSW, or LPHA are individuals that are licenced. Having the appropriate competent staff is essential to make sure that not only the agency is compliant with state requirements but also that the clientele obtains the appropriate services. As a CEO I would want to make sure that my staff is knowledgeable and aware of services and regulations to complete their role duties. Below are some links that are useful such as Rule 132 which is important for all staff in mental health to have some knowledge about the rule. Also, having the credential staff helps for billing purposes as the higher the level of education the higher the fee for services. Attached are the billing codes to get an idea of how the agency gets paid per service per staff credential. https://www2.illinois.gov/hfs/SiteCollectionDocuments/CommunityBasedBehavioralHealthFeeScheduleEffective10012021.pdf (Links to an external site.) .
The second activity I would address as a CEO is making sure everyone is trained on writing clinical notes. Clinical notes are important as they tell the story of the interventions done by staff and outcome of services and consumer progress. At our current location we are retraining staff on clinical notes both Soap notes and Pie notes. Case workers are getting trained on writing notes based on medical necessity. Which means that the reason for services and interventions need to be justified to continue getting authorization. When notes are not enough to justify or have evidence that the intervention is effective the agency gets denials which causes the client not to receive services needed. As a CEO I would like to make sure that my staff is creditable, knowledgeable and properly trained to provide a great quality of service.
References:
Nguyen, D. (2010). The health care reform bill: Compliance implications for behavioral and mental health services. Journal of Health Care Compliance, 12(4), 11-14, 61.
Website for Insight :
For Billing Guidance : Community Mental Health (CMHC)
Rule 132-Guidelines for CMHC
Process to Certify as a CMHC
Insurance Claims for Authorizations (Meridian)
|
Suppliers |
Guided Response: Respond to at least two of your classmates’ posts in a substantive manner. Some ways could include examples, current events, and/or possible outcomes. Must use references.
Vincent’s Post;
Hello Class,
As a firm decides whether or not it should have fewer or more suppliers, it needs to take into consideration what kind of business it is running and how the organization operates as a whole. Companies that offer a breadth of products such as large retailers (Amazon, WalMart, Target, etc.) will most likely have a large number of suppliers. This is because these types of organizations offer such a wide variety of products that a single or just a few suppliers would not only be able to meet the demands of their product mix, but also insufficiently keep up with the high output of products that these companies sell. On the other hand, smaller or more niche focused organizations that sell or produce specialized products may only have one or a select few number of suppliers. This could be due to a certain supplier being the only supplier available that supplies a specific product or part that is vital to the niche product being manufactured. Also, smaller organizations that produce or sell a narrower variety of products don’t necessarily need multiple suppliers and doing so could actually complicate operations.
Some advantages with having multiple suppliers would be that your options for solutions can be broader. If something were to go wrong with one supplier and another supplier you were working with could provide a solution or substitution, this would save the hassle of having to look around and find a whole new supplier. Multiple suppliers also tend to drive competition within the suppliers and can lead to lower costs for the organization. Alternatively, having a large number of suppliers for your organization can lead to many complications within the supply chain and would require a larger workforce to ensure this process of the business is running smoothly.
Advantages with only having a few or just one supplier could include building strong relationships with these suppliers over time from a business standpoint. These types of relationships can lead to frictionless business operations as overtime supplier and organization can come to understand how each other works. These relationships can also have small perks such as loyalty discounts if suppliers offer such things. On the other hand, relying on a select few or just one supplier can be sort of a “all your eggs in one basket” type of situation. When relying on a single supplier, risk of failure could be detrimental if a supplier fails you because you wouldn’t have another supplier in your books that could substitute for the time being.
Vonderembse, M. A., & White, G. P. (2013). Operations management [Electronic version]. Retrieved from https://content.ashford.edu/
Federico’s Post:
Suppliers
When deciding a supply chain strategy with dedicated or multiple suppliers, an organization must weigh several factors. The decision must consider the pros and cons of each approach. Suppose the company elected to work with various suppliers. In that case, it will reduce the risk of running out of material inventory, but at the same time, will add complexity to its supply chain by increasing the participants to share the company’s purchasing information. According to Vonderembse & White (2013), by using a variety of suppliers, the company will take advantage of the competition between them, which will help in reducing the cost of their supplies (chap. 5.4).
On the other hand, having few or even a single supplier strategy will require the company to develop reliability and responsiveness on such a supplier. The company will benefit by easily integrating their information databases systems, like Electronic Data Interchange (EDI) or Material Requirements Planning (MRP). But also having single-sourcing could create dependency, increasing vulnerability and risk of supply interruption. However, Nelson (2013) states that “Splitting demands would only make the supplier less responsive and would make it more difficult for them to dedicate resources to resolving quality and capacity issues” (p. 4).
In summary, the proper supply chain management decision will also depend on the business sector or even the organization’s size. A smaller company could have less flexibility in choosing suppliers. Large focal firms usually have strong negotiation power, reaching beneficial agreements with several suppliers, which will considerably reduce their purchasing prices. This situation is a reality in the steel company where I work. The centralized purchasing system, based on SAP, will allow the employees to buy products from many retailers, like Grainger or Motion Ind, with discounted prices up to 15% below regular internet prices.
References
Vonderembse, M. A., & White, G. P. (2013). Operations management. Bridgepoint Education.
Nelson, J. (2013, February 28). Evaluating Supply Chain Risks with Single vs. Multiple Vendor Sourcing Strategies. https://spendmatters.com/2013/02/28/evaluating-supply-chain-risks-with-single-vs-multiple-vendor-sourcing-strategies/