Financial Information and the Decision-Making Process
The chapter called Financial Information and the Decision Making Process is dedicated to the consideration of decision-making process in terms of financial information in health care organizations. The author insists on the fact that the increasing significance of cost criteria is closely connected with the rapid development of the medical equipment. In that regard, the chapter reveals decision-making process as crucial in handling the information. Further, the chapter enlarges on the relevant use of the data volumes to be able to evaluate the financial conditions and supervising effectiveness. The chapter discovers the effective tools and techniques in cost finding in ownership organizational hierarchy. This chapter is rather helpful for my future job because it represents a better idea of rational use of financial information.
While reading the chapter, several questions occur to mind. First, if a person wants to connect his life with health care, is it obligatory to enter the accounting courses in order to handle the financial information? The issue is urgent because, the answer may influence the outlook on the current education curriculum. Next, does the person that is in the accounting could make a better decision than a person who is beyond it? The chapter can save the time for additional accounting courses.
As the health care segment of economy is constantly growing, the chapter is of significant value as it encourages the understanding of the current financial situation and simplifies the process of decision-making. With the help of this book, it will become easier to handle the issues in accounting and to use the financial information in the most appropriate way. Additionally, as the health care organization feels the necessity to adjust to the considerable changes in the current financial environment, the material presented in this chapter will help to reduce this gap.
Billing and Coding for Health Services
Billing and Coding for Health Services is the next reading that discloses specific information about the revenue cycle for healthcare companies, identifies different types of payment such as billing and charging, and, finally reveals the role of the information coding. In my opinion, the most valuable material presented in this chapter is the description of five stages of revenue cycle since it fosters the comprehension of scope of accounting and its role for the information arrangement in the health care organization. The material presented in the chapter will be rather helpful for the organizations to advance the level health care services for their patients thus improving the image of the company.
While analysis the material, I came across that the description of the billing process and the security issues. Does the organization guarantee that information coding is the safest method of the information storage? Is it necessary to use the extra service of outside insurance companies? The personal experience shows that ignorance of the specific information and of the accounting principles may lead to the aggravation of the financial treatment in financial terms.
The given chapter helps to understand the scope of the revenue cycle and the importance of accuracy of the billing and charging both for a company and for patients. Very often, the practice shows that inconsistent organization of the financial issues might negatively influence the quality of patient’s treatment. In this respect, the discussed material is indispensable in as it fills the necessary gaps in the successful chains of health care operations.
Financial Environment of Health Care Organizations
The information provided by the chapter headed Financial Environment of Health Care Organizations explains the necessity to take budget planning and service organization into a deeper consideration. In other words, the chapter discusses the advantages of financial viability scanning and presents the bright example of what consequences it might lead by ignoring this sector. Considering this, the health care organizations acquire the role of mediator between the suppliers and the community so that they appear in the center of money circulation. The author logically proves that the awareness of the scope of financial operation is crucial for medical care companies to be successful.
Owing to the fact that the chapter suggests the salaries paid to the employees is an important matter to consider. Evidently, the successful handling the money allocation also greatly influences the service level. Then, a question arises whether the degree of involvement into the money circulation since many organization rely mostly on the government and other establishments in decision-making so that a heath care professional could fail to realize the financial position of the organization.
The chapter under consideration provides in-depth information about the essence of the budget planning. The prompts are rather useful for me as a future health care professional due to the presentation of the corporate side of business in this abstract. People who work in the medical sphere must be capable to evaluate the economic environment in order to keep face with the current situation in the health care segment. Additionally, the information could be easily applied in practice due to the bright examples provided in this chapter that illustrate how the concrete problems could be solved and how the theory could be used in practice.
Legal and Regulatory Environment
The next chapter called Legal and Regulatory Environment focuses on the legal issues and the problems connected with them. Here, the writer emphasized the importance to consider the law for the organization to eliminate the financial risks caused by ambiguous situations. The information presented in the second objective explaining the difference between the fraud and abuse is of great value for the professional in the medical sphere. In this chapter, the author also reveals such important issues as False Claim Act and some other significant organizational implications that present the detailed screening of the patients’ claims and needs. In a whole, the chapter covers the basics of the legal code that is applicable to the health care in order to eliminate the possible risks.
As the chapter touches upon the financial issues in legal terms, it causes many questions concerning the current legal situation and leaves much to be desired. The practice shows that the majority of problems are mostly connected with the financial risks and in case the medical care ignores the law, it can suffer considerable losses. The next problem that is also connected with insurance issues of the patients the lawsuit procedures. In that regard, the chapter briefly presents the essentials of the law.
The chapter is useful because it mostly focuses on the most important issues of financial management and regulatory principles. What is more crucial is that the chapter concerns human rights as well as the rights of the legal entities. Therefore, the health care establishments should have a separate department informing the employers and the employees about the legal principles.
Revenue Determination
Revenue Determination specifies the concept the second chapter thus enlarging on the payment methods and general price policy in the health care segment. The writer supports the idea that monetary policy on of the inherent elements of the financial arrangement. Additionally, the chapter identifies the basics of the successful negotiation between the employee and the patients and covers such issues as price ethics and payment arrangement. Another key point that attracted my attention is the consideration of adequate price setting and money administration.
Very often, the medical establishments pay little attention to the pricing and therefore they do not realize the importance of this policy. The negotiation and scheduling cover the psychological issues so that money and psychology are closely connected. Hence, there is the necessity to decide the extent of psychology introduction into negotiation since it is also the part of business ethics. The second question is whether payment schedule is the major problem of the medical care or not. If so, then what concrete issues could support that idea? Here, negotiating concept may resolve many disputes.
The readings present in-depth information about the generic principles of contract negotiation and pricing management. The prompt could be valuable both for student and for those who want to connect their future profession with health care management since it involves many theoretical and practical issues that blend the topic of finance and accounting. The chapter can serve as an effective guideline in the major principles of business ethics and formal behavior. Finally, the information greatly promotes the understanding of the concept of patient treatment in financial terms.
Managed Care
The chapter under consideration explores the idea about the effective care management in terms of cost reduction and the quality of medical care. It explains how to find the equilibrium between techniques and services applied to other organizations and the concept of delivery systems. According to the author, the managed care helps to avoid the extra costs and no to lose the quality of patient treatment. Regarding that, the writer covers such financial issues as marketing, salary and budget, capitation and price settling. As it can be viewed, the content of the chapter is based on the ideas of previous chapters thus testifying the consistency of thoughts and validity of the facts.
While looking through the reading the first question that came to mind is there the balance between the quality of medical care and the cost level. The first question causes the next question: what issues should attach the most attention in order to enhance the competitiveness of this or that organization. To cognate the thrust of healthcare industry, medical care executives should include cost-control system. The practical side also proves that the inappropriate approach to the cost supervising might cause unnecessary losses.
Considering this chapter and taking into consideration the previous ones, the chapters may appear helpful for the students in mastering manage care techniques and for the medical professionals in practicing new methods of utilization reviews and quality improvement programs. Moreover, the chapter provides coherent information that helps to find the alternative methods of enrollees’ encouragement and care efficiency. Finally, the information introduces the employers to the financial standards for the health organizations to be achieved.
Reference
Cleverly, W. O., & Cameron, A. O. (2006). Essentials of Health Care Finance. US: Jones and Bartlett Publishers.