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BHA-FPX4006 u02a1 - Compliance Program Implementation and Ethical Decision Making Learner: Darion , Alexander

OVERALL COMMENTS Hi Darian, I think you completed this assignment before you received the feedback on Assignment #1. The writing

and formatting errors are the same. It is probable that you include all of the information, but it is not clearly supported

by theory and the literature to demonstrate our understanding. Use the comments in rubric to guide your revision.

Highlight in yellow all additions and corrections. Dr. Suz

RUBRICS

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CRITERIA 1

Describe major categories of health care fraud and abuse, including the billing practice known as upcoding.

COMPETENCY

Analyze health care laws and regulations from a local, state, and federal level.

NON_PERFORMANCE:

Does not describe major categories of health care fraud and abuse, including the billing practice known as

upcoding.

BASIC:

Lists but does not describe major categories of health care fraud and abuse, including the billing practice

known as upcoding. Omissions and/or errors exist.

PROFICIENT:

Describes major categories of health care fraud and abuse, including the billing practice known as

upcoding.

DISTINGUISHED:

Analyzes major categories of health care fraud and abuse, including the billing practice known as upcoding.

Analysis includes multiple examples, specifics, and references to current, authoritative sources, such as

government websites.

Comments:

One source was used to support your description of the major categories of health care fraud and abuse. The

reference page must match intext citations.

CRITERIA 2

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Propose a list of evidence-based recommendations based on information from the Office of the Inspector General to identify and address upcoding within a health care organization.

COMPETENCY

Assess the importance of continuous readiness in the health care organization.

NON_PERFORMANCE:

Does not propose a list of evidence-based recommendations based on information from the Office of the

Inspector General to identify and address upcoding within a health care organization.

BASIC:

Proposes a list of recommendations to identify and address upcoding within a health care organization.

Not all recommendations are evidence-based or based on information from the Office of the Inspector

General. Omissions and/or errors exist.

PROFICIENT:

Proposes a list of evidence-based recommendations based on information from the Office of the Inspector

General to identify and address upcoding within a health care organization.

DISTINGUISHED:

Proposes a list of multiple evidence-based recommendations based on information from the office of the

Inspector General to identify and address upcoding within a health care organization. Recommendations

include multiple examples, specifics, and references to current, authoritative sources, such as government

websites.

Comments:

CMS was the only citation used to support the evaluation of the OIG recommendations. Be sure that the

source of your information is clearly identified.

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CRITERIA 3

Provide a synopsis of five laws relating to health care fraud and abuse.

COMPETENCY

Explain how governing body and regulatory agency standards exercise oversight authority within a health

care organizational setting.

NON_PERFORMANCE: Does not provide a synopsis of five laws relating to health care fraud and abuse.

BASIC:

Provides a synopsis of five laws relating to health care fraud and abuse; however, omissions and/or

errors exist.

PROFICIENT: Provides a synopsis of five laws relating to health care fraud and abuse.

DISTINGUISHED:

Provides a succinct synopsis of five laws relating to health care fraud and abuse. Synopsis includes multiple

examples, specifics, and references to current, authoritative sources, such as government websites.

Comments:

The five laws were explained. Your summary needs citations to meet the synopsis criteria. It should be

synopsis of the literature related to theses five laws.

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CRITERIA 4

Explain one law that pertains to the practice of upcoding.

COMPETENCY

Explain how governing body and regulatory agency standards exercise oversight authority within a health

care organizational setting.

NON_PERFORMANCE: Does not explain one law that pertains to the practice of upcoding.

BASIC:

Attempts to explain one law that pertains to the practice of upcoding; however, omissions and/or errors

exist.

PROFICIENT: Explains one law that pertains to the practice of upcoding.

DISTINGUISHED:

Explains one law that pertains to the practice of upcoding. Explanation includes multiple case examples,

specifics, and references to current, authoritative sources, such as government websites.

Comments:

The practice of upcoding was explained. There were no supporting citations.

CRITERIA 5

Develop a clear, concise, organized, and generally error-free workplace brief that provides evidence-based recommendations about how to identify and address the incorrect billing practice of upcoding.

COMPETENCY

Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity

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of others and is consistent with the expectations of health care professionals.

NON_PERFORMANCE:

Does not develop a clear, concise, organized, and generally error-free workplace brief that provides

evidence-based recommendations about how to identify and address the incorrect billing practice of

upcoding.

BASIC:

Attempts to develop a clear, concise, organized, and generally error-free workplace brief that provides

evidence-based recommendations about how to identify and address the incorrect billing practice of

upcoding; however, significant lapses, omissions, and/or errors exist.

PROFICIENT:

Develops a clear, concise, organized, and generally error-free workplace brief that provides evidence-based

recommendations about how to identify and address the incorrect billing practice of upcoding.

DISTINGUISHED:

Develops a clear, concise, organized, and error-free workplace brief that provides evidence-based

recommendations about how to identify and address the incorrect billing practice of upcoding. Brief includes

multiple case examples, specifics, and references to current, authoritative sources, such as government

websites.

Comments:

Download a free copy of Premium Grammarly and use it to check and correct your work. 

Identify all acronyms in their first use. e.g. HIPAA.

Use the supplemental feedback to improve content and formatting. 

Center all headings per APA 7th edition requirements. 

Be sure all citations and references are clearly identified.

Do not use bullet points in scholarly writing. Write in complete sentences using the MEAL Plan found in the

writing center to develop proper paragraphs using complete sentences.

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Supplemental Feedback

SUPPLEMENTAL CRITERIA 1

Purpose Compose a text that articulates meaning relevant to the main topic, scope, and purpose of the prompt

BEGINNING: This text is unrelated to the assignment prompt.

DEVELOPING:

This text is related to the assignment prompt but does not demonstrate an understanding of the main

topic, scope, and purpose.

SKILLED:

This text responds to the assignment prompt and appropriately addresses the main topic, scope, and

purpose.

ADVANCED:

This text presents a focused response to the assignment prompt and demonstrates a thorough

understanding of the main topic, scope, and purpose.

Comments:

The connection between this text and the assignment prompt is unclear to me. To develop this connection,

consider revisiting the prewriting stage of the writing process. It may also be helpful to narrow your focus and

develop an outline.

Resources

Develop Strong Flow

Explore the Prewriting Stage of the Writing Process

Learn about Organizational Techniques

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SUPPLEMENTAL CRITERIA 2

Organization Develop text using organization, structure, and transitions that demonstrate understanding of relationship between main and subtopics

BEGINNING:

This text does not include a thesis statement and is organized inappropriately for the assignment.

DEVELOPING:

The thesis statement in this text is unclear and/or the text is presented in paragraphs with unclear main

idea(s) and/or transitional phrases.

SKILLED:

This text includes a thesis statement and is organized into paragraphs, with clear main ideas and effective

transitional phrases.

ADVANCED:

This text reflects a strong thesis statement. Additionally, this text is organized with skillful transitions into

paragraphs with clear main ideas, sufficient evidence, analysis, and linking information.

Comments:

This text will be strengthened by including a more specific thesis statement and/or further developing the

main idea, evidence, analysis, and/or linking information in each paragraph. Consider reverse outlining your

text to strengthen your organization.

Resources

Organize Ideas for Your Paper

Explore Paragraphing Techniques

Reverse Outline Your Existing Text

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SUPPLEMENTAL CRITERIA 3

Evidence Integrate into text appropriate use of scholarly sources and evidence

BEGINNING: This text included plagiarized information.

DEVELOPING:

This text lacks synthesis of information from sources and/or the credibility of the sources is questionable,

with many flaws in APA citation style.

SKILLED:

The included evidence was integrated and synthesized from outside sources, most of which are scholarly,

with minimal flaws in APA citation style.

ADVANCED:

The evidence in this text was integrated and synthesized from credible, scholarly, and professionally sound

sources, with minimal flaws in APA citation style.

Comments:

This text includes evidence, but the credibility of and/or citation of some of those sources falls short of

academic standards. Consider your research strategies by visiting Capella's library, and study citation

guidelines regarding quoting, paraphrasing, or summarizing material from outside sources.

Resources

Quote, Paraphrase, and Summarize Effectively

Learn to Interpret Evidence

Get Started with the Library

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SUPPLEMENTAL CRITERIA 4

Tone Apply in text the standard writing conventions for the discipline, including structure, voice, person and tone

BEGINNING: Text uses language inappropriate for the intended audience.

DEVELOPING:

This text does not meet writing conventions for the discipline and lacks appropriate voice, person, and/or

tone for the intended audience.

SKILLED:

This text meets writing conventions for the discipline and there were minimal issues in appropriate use of

voice, person, or tone for the intended audience.

ADVANCED:

This text exhibits strict adherence to writing conventions for the discipline and uses appropriate voice,

person, and tone for the intended audience.

Comments:

This text lacks appropriate voice, person, and/or tone for the intended audience. In your writing process,

consider the expectations of your audience. Additionally, it may be helpful to study the Writing Center's

resources on developing a scholarly voice.

Resources

Develop Your Scholarly Voice

Explore Active and Passive Voice

Use the Correct Person

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SUPPLEMENTAL CRITERIA 5

Sentence Structure Produce text with minimal grammar, usage, spelling, and mechanical errors

BEGINNING:

Text meaning is unclear due to errors in sentence structure, grammar, usage, word choice, spelling, or

mechanics in 75% or more of text.

DEVELOPING:

Text meaning is interrupted due to sentence structure, grammar, usage, word choice, spelling, or

mechanical errors in 25%-75% or more of text.

SKILLED:

Text conveys clear meaning with minimal issues in grammar, usage, word choice, spelling, or mechanical

errors in 10%-25% of text.

ADVANCED:

Text complexity and concision conveys clear meaning, with grammar, usage, word choice, spelling, or

mechanical errors in 10% or less of text.

Comments:

Many of your ideas are communicated in grammatically unsound sentences. So that the meaning of your

messages is communicated clearly, study sentence structure guidelines and practice sentence revision to

strengthen your text.

Resources

Consider Sentence Structure and Variety

Study Subject-Verb Agreement

Revise Your Sentences