This will require you to select and interview a person who is employed within your chosen profession/industry.

The purposes for this assignment:1.To help you gain insight into a career of interest to you.2.To gain experience in information interviews and networking.

THE INTERVIEWED PERSON’S ORGANIZATION: It can be for-profit, non-profit, religious,political, or educational. The interview could be someone you are meeting for the first time, or someone you already know. It’s okay if they are a relative of yours, or someone with whom you have worked or now work.

THE INTERVIEW: Interviewing them in person is preferred. It is preferable that you interview them in their typical work environment.

REPORT IMAGE QUALITY: This assignment MUST NOT BE HAND WRITTEN!!! Use a computer.Make a copy for yourself and submit one copyto me.

WRITE-UP STYLE: Simply structure your report in a question and answer format.
For example:Question # 1: What is your official title? How long have you been in this line of work?
Answer: Mr. John Smith is the Director of Marketing for Airborne Express. He has worked in Marketing for five years and in the shipping industry for ten years…
This paper should NOT be written in paragraph form. In other words, this paper should not be written as an English composition, but as an interview.

WORDING: Your report should have completely thought out and thorough answers, not brief answers such as yesor no. Occasional direct quotesare acceptable, but the vast majority of this assignment must be in YOUR own words.

GRADING: Ask the questions, and tell me in your own words what they said in response to each question. Please inform me of any questions in which you experienced difficulty or lack of response from your interviewee.REQUIRED QUESTIONS TO ASK DURING

THE INTERVIEW:1.What is your official title? How long have you been in this line of work?
2.Describe a typical day in your line of work (if he/she says there is no suchthing as a typical day, ask them to explain their job functions)
3.What education, training and credentials did you have to get in order to work inthis career?
4.What do you likemost about your job?
5.What do you like least about your job?
6A How do you formally communicate with other members of the organization? (meetings, presentations, reports, etc.)
6B How do you informally communicate with other members of the organization? (email, text message, etc.)
7. Do you have any additional commentsor suggestions? (optional)
8. Add 2 or 3 questions of your own.

Heath care reimbursement is the study of reimbursement for services rendered to a person in which an entity other than the receiver of the service is responsible for the payment. Third-party reimbursement for the cost of a subscriber’s health care is commonly paid in full or in part by a health insurance plan, such as Blue Shield or Blue Cross, Medicare, or Medicaid. (Mosby, 2009, p. 436). The purpose of studying healthcare reimbursement is to become proficient in billing and coding so that health care providers can be paid and continue to provide quality healthcare to patients. By completing this project you will demonstrate your understanding of medical reimbursement; a skill used by medical assistants in the workplace.
Course Outcomes:
1. Define basic health insurance terms & abbreviations.
2. Analyze and discuss insurance plans.
3. Analyze the legal and ethical impact of fraud and abuse.
4. Use CPT, ICD and HCPCS coding systems to complete claim forms.
5. Evaluate the impact of reimbursement from various plans with regard to effective practice management.
6. Reflect on the impact of health care reimbursement policies to individuals and providers.

MAERB Competencies Evaluated in this Project
Third Party reimbursement VIII.C
1. Identify
a. Types of third party plans
b. Information required to file a third party claim
c. The steps for filing a third party claim
2. Outline managed care requirements for patient referral
3. Describe processes for:
a. Verification of eligibility for services
b. Precertification
c. Preauthorization
4. Define a patient-centered medical home (PCMH)
5. Differentiate between fraud and abuse
Procedural and Diagnostic Coding IX.C
1. Describe how to use the most current procedural coding system
2. Describe how to use the most current diagnostic coding classification system
3. Describe how to use the most current HCPCS coding
4. Discuss the effects of:
a. upcoding
b. downcoding
5. Define medical necessity as it applies to procedural and diagnostic coding
Case Study I
As the Medical Insurance Specialist individuals addresses all the tasks that are completed by administrative staff members during the medical billing process. You will prepare an analysis of the case study as it relates to the questions below, using knowledge gained from in-class discussions.
Scenario: A patient shows the following insurance identification card to the Medical Insurance Specialist for medical treatment for the following medical treatment: Richard Moore COPD flare: Patient has a long history of COPD requiring multiple hospitalizations. Inpatient status is required secondary to hypoxemia, for which supplemental oxygen is needed, aggressive bronchodilator therapy and the risk of rapid deterioration. In anticipation of discharge the patient will require home health services.
Notice to Members and Providers of Care
To avoid a reduction in your hospital benefits, you are responsible for obtaining
Certification for hospitalization and emergency admissions. The review is required
Regardless of the reason for hospital admission. For specified procedures, Second
Surgical Opinions may be mandatory.
For certification, call Utilization Management Services at 800-837-8808:
• At least 7 days in advance of Scheduled Surgery of Hospital Admissions.
• Within 48 hours after Emergency Admissions or on the first business day following
Weekend or holiday Emergency Admissions.
CONNECTICUT PILGRIM HEALTHPLAN C/O
Robert S. Weiss & Company
Silver Hill Business Center
500 S. Broad Street
P.O. Box 1034
Meriden, CT 06450
(800) 466-7900
THIS CARD IS FOR IDENTIFICATION ONLY AND DOES NOT ESTABLISH ELIGIBILITY FOR
COVERAGE BY CONNECTICUT HEALTH PLAN. Please refer to your insurance booklet

CONNECTICUT PILGRIM

INSURANCE INFORMATION
I.D.#: 1002.9713
Employee: RICHARD MOORE
Group #: A0000323
Eff. date: 03/01/2010
Status: Dependent Coverage? F
In-network: $25 Co-Pay
Out-of-network: $250 Ded; 80%/20%

Front Card

Directions: You will prepare an analysis of the case study as it relates to the questions below. When completing this assignment use complete sentences.
1. Identify What Type of Health Plan
o What type of third party plan is in the case above?(VIIIC1a)
o What information is required to file a claim in the case above? (VIIIC1b)
o What steps are required to file a claim in the case above? (VIIIC1c)
o Outline the required procedure for obtaining a referral. (VIIIC2)
o What steps are required to verify if the patient is eligible for services, before the patient can be admitted to the hospital? (VIIIC3a)
2. In the treatment of Outpatient and Inpatient service will Mr. Moore need a referral or preauthorization? Explain why and describe the process. (VIIIC2; VIIIC3c)
3. Prior to discharge the patient needs precertification for home health services. What is the process for obtaining precertification for these services? VIIIC3b)
4. Define a patient-centered medical home service. (VIIIC4)
5. Describe and identify the difference between fraud and abuse. Provide at least one example of each.

African Culture Short Essay
Essays are to be four pages, include a works cited page and use five academic sources/citations to support view. Students can use sources provided in class, but the majority of sources must be found through independent research.
Academic Sources only accepted: Major news publication, government institutions, Museums, Books and Journals.
Research paper: Research a specific topic related to a specific sub-Saharan African country or ethnic group in the modern era (1500 AD-present).Use a variety of sources to research the topic and report the findings back in a short research paper.

Conflict Diamonds and Modern Sierra Leone –
Include Thesis with Support Ideas/Details. Compare
List of the key similarities and differences/ provide history of Conflict Diamonds and Modern Sierra Leone.

Briefly, describe the Alcohol Anonymous group therapy, and answer the following questions:

Which type(s) of psychotherapeutic techniques is being used in the group?

If you had the same problem(s) as the intended audience of the group, would you have found it helpful? Why or why not?

Sources/articles should not be older than 10 years.

Liberal Arts Essay
Value of a Liberal Arts Education Essay: Write an essay (3-5 pages double-spaced) on the value of a liberal arts education. You should cite at least two references and at the end of the paper discuss your personal and professional goals as they relate to a liberal arts education. All papers should be done in APA format for your in-text citations and reference page. Here is a tutorial that will explain the proces

Work related illness or injury, requiring emergency services. Fully describe Er visit medications, monitoring, procedures, discharge instruction

What is the evidential argument from evil? Drawing upon the theodicies discussed in class, discuss in detail what you think may be the most plausible response to the evidential argument from evil. What objections can be raised to that theodicy and to your argument?

Compose a 3- to 4- page paper that:

Defines hidden curriculum in your own words.
Explains two examples from your classroom practice that represent hidden curriculum. One example should represent a negative implication of hidden curriculum, and the other a positive implication of hidden curriculum.
Explains one action you will take to repair the effects of negative hidden curriculum. Provide a rationale for your action using specific references to the Learning Resources.
Explains one example to include in your classroom that represents positive hidden curriculum. Provide a rationale for your action using specific references to the Learning Resources.
Explains how you will use hidden curriculum to meet the diverse learning needs of the students in your classroom. Include an explanation as to how your actions relate to at least one of the RWRCOEL Professional Dispositions, Diversity Proficiencies, and Technology Proficiencies.

You must:

Cite 1/3 dispositions or proficiencies.

Optional to cite: ASCD. (2015).

Cite this source 1-2 times: Henson, K. T. (2015). Curriculum planning: Integrating multiculturalism, constructivism, and education reform (5th ed.). Long Grove, IL: Waveland Press.

Chapter 1, “An Introduction to Curriculum Development” (pp. 1–40)

cervical cancer prevention education for Asian women aged 25 to 40
1. identify heath promotion and disease prevention issues specific to the age, group,sex,and nationality stated
2.develop a plan of care/teaching for this group after research this topic. include the references and indicate if there is any new information or not. Indicate how the information adds to nursing knowledge in the area of heath promotion and disease prevention in this group and in general with inclusion of Nursing intervention classification NIC and nursing outcome classification NOC
3. must references at least 2 scholarly journal/ one must be nursing journal

Write a 1,200- to 1,500-word paper answering the following questions that are at the end of the case study on pg. 517.

What are the facts of this case?
What are the management implications of this case? What should management be doing to protect their employees?
If Rosemary had been injured, who would have been responsible? What if the visitor attacked another patient? What are the legal and ethical obligations GCH has to its employees and to its patients and how do they apply to this case?
What would be the optimum physical space for these patients? How much do you think it would cost to install a panic alarm in the patients’ rooms? At the nurse’s station? A safe room? What are the costs of doing nothing?
Create an emergency plan for the staff in this unit while they await administration’s decision on renovations.
Reference your readings and include a minimum of 5 peer-reviewed, scholarly, or similar articles.

Format your paper according to APA guidelines.