Module 6

Running head: COMPLIANCE PLANS 1

COMPLIANCE PLANS 5

Keri King

Module 4

10/27/19

Nurse charges for Diabetes Management Education as a Physician Visit

Diabetes self-management training or education is regarded as being one the most cost-effective means that has the potential of improving healthcare outcomes for most patients. Diabetes management educators are given the mandate to provide not only training services, but also to enable their co-workers to offer comprehensive healthcare services to patients suffering from diabetes (Fitzpatrick & Kazer, 2012). Therefore, what this implies is the fact that they aid in bringing a set of unique skills to physicians, thus making them to be one of the adjuncts of primary health care.

Ideally, diabetes educators have various tasks to accomplish as much as health care management is concerned. For instance, they assist diabetic patients to come up with various skills that will enable them to manage their illness. They also assist in improving clinical practice efficiency through assuming various time-consuming activities such as follow-up tasks, counseling, and patient training. Even though they also serve as extensions of the healthcare professional practice, they also assist in ensuring that health care provided are up to standard. Diabetic educators, especially pharmacists, nurses, dietitians, as well as other healthcare professionals also dedicate their time in counseling patients on how to properly integrate clinically proved medical behaviors or skills into their lives (Fitzpatrick & Kazer, 2012). This then makes such an activity to be one of the most collaborative, interactive, as well as an ongoing procedure involving diabetic educators, diabetic patients, and their families. The following are the main compliance plans that ought to be followed;

1) Becoming an accredited DSMT (Diabetes self-management training) program) – in order to be in the position of obtaining Medicare reimbursement, it is important for nurses to ensure that they are part of the accredited DSMT program. The same program should also meet all the approved standards, especially NSDSME (national standards for diabetes self-management education) that aid in representing the guiding standards or principles for quality DSMT.

2) Establishing friendship with other departments - because it is vital to establish a good working relationship with other health care team members, it is also important to take consideration the significance of forming a cooperative relationship with everyone. The reason for that is because it will assist in smoothening the way for fruitful compensation for DSME services offered. This will ultimately include finance staff, compliance officer, billing department, and the therapeutic record department (Gerstein & Haynes, 2001).

3) Obtaining qualified treating physician referral and permission for patients’ appointment – in most cases, Medicare demands referrals for DSMT health care services from the healthcare professional who could have been managing the beneficiary of the diabetic patient. The significance of such a referral is that it incorporates important information needed for the DSMT and MNT Medicare requirements.

4) Learning about diagnosis (ICD-9) and health common procedural coding system (HCPCS) codes for compensation or reimbursement – the reason as to why it is important to learn about the HCPCS codes is because they contain national codes for supplies and procedures that are not clearly defined by CPT (current procedural codes).

5) Documenting DSMT services – in order to be in the position of obtaining reimbursement or compensation for DSMT services, it is important for a person to ensure that he or she has accurately documented the services he or she had initially provided.

6) Tracking DSMT services and compensation or reimbursement- it is important to track DSMT services as well as its compensation because it provides detailed information concerning patient visits, nursing practice to diabetic patients, the DSMT services physicians provide, and compensations for the same services provided.

7) Marketing DSMT services as well as proactively seeking reimbursement –DSMT is one of the fundamental parts of the diabetic health care plans because it assists diabetic patients to improve their therapeutic outcomes. Although some of the diabetes health care team members might be well informed about the importance of DSMT, it is important to remind each other about the same periodically (American Diabetes Association & University of Michigan, 2014).

Many employees are not able to fulfill the requirement to discuss the facilities Mission Statement and Vision Statement

According to modern research, it is evident that the mission and the vision statement of the company are always tied up on the achievable goals of the workers. Once the vision and the visions of the company have been framed in this manner, it implies that it will be easier to integrate some of the main organizational parts into achieving the day-to-day operating capacities of the company. What this implies is the fact that it is the responsibility of each worker to ensure that he or she has executed his or her job as required into the system so as to make it easy for the company achieves the goals of its establishment (Chisholm et al., 2014).

In connection with that, it is evident that the mission and the mission statements of the company is something that has been realized to emanate from various processes that are suited for the purpose of nurturing as well as culturing the needs of the organization. Moreover, it is important to ensure that the institutional budgeting priorities have been aligned with the mission statement of the organization. The following are some of the procedures that ought to be followed in order to achieve the mission and the vision statement of the organization

a) Ensuring that each team member have accurately executed his or her task as required – once the management authority has detailed all that is required from each employee, it will be easier to improve the output of each worker. On the other hand, their duties will be based on the mission and vision statement of the company from the time of their recruitment (Swansburg & Swansburg, (2002).

b) Promoting the vision and the mission of the company through making it visible to all stakeholders – to the management authority, it is important to ensure that the mission and the vision statement have been regarded as being the focal point for development. Ideally, there is the need of ensuring that both the mission and the mission statement of the organization remain to be reliable and concise to each worker at each level.

c) Using story telling techniques – in order to be in the position of improving workers’ output, it is important to use various story telling techniques. The reason for that is because it has been provided to have the ability to induce a positive impact to the vision and mission statement of the organization. This becomes an effective strategy the organization can use in sharing the success of its workers with other team members (Swansburg & Swansburg, 2002).

References

American Diabetes Association., & University of Michigan. (2014). Life with diabetes: A series of teaching outlines Michigan Diabetes Research and Training Center.

Chisholm-Burns, M. A., Vaillancourt, A. M., Shepherd, M., & Ovid Technologies, Inc. (2014). Pharmacy management, leadership, marketing, and finance. Burlington, MA: Jones & Bartlett Learning.

Fitzpatrick, J. J., & Kazer, M. W. (2012). Encyclopedia of nursing research. New York, NY: Springer Pub.

Gerstein, H. C., & Haynes, R. B. (2001). Evidence-based diabetes care. Hamilton, Ont: BC Decker.

Swansburg, R. C., & Swansburg, R. J. (2002). Introduction to management and leadership for nurse managers. Boston [u.a.: Jones and Bartlett.

Swansburg, R. C., & Swansburg, R. J. (2002). Introduction to management and leadership for nurse managers. Boston [u.a.: Jones and Bartlett.