HCA320-Week 7-Assignment..docx - Running head FLOW OF FUNDS...

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Running head: FLOW OF FUNDS WITHIN AN ORGANIZATION 1 The flow of Funds within an Organization Aspen University Author Note HCA320: Healthcare Policy & Economics Professor Vivienne Pierce McDaniel, DNP, R.N. February 24, 2020 The flow of Funds within an Organization
THE FLOW OF FUNDS WITHIN AN ORGANIZATION 2 The flow of funds is how cash originates and where it terminates. It is the inflows and outflows of cash from one department to another. The flow of funds is measured and recorded in funds flow account statements on a monthly or quarterly basis. The department of health needs to track this fund flows to understand how the funds are earned, spend, and allocated among the education, research, and clinical care missions of the institutions. Hospitals and other healthcare organizations receive funds from private pays and third-party reimbursement. Private pays come directly from the patient's out of pocket payments for medical services provided while third party reimbursement is received from the insurance companies covering the patient medical bills and heal like the Anthem, Blue Shield, or Medicaid or Medicare (Casto & Forrestal, 2013). The purpose of this paper is to explain the flow of funds within an organization including private pay and third-party reimbursement, how to prevent abuses and inefficiencies in third party payments, the definition of funds in the care organizations challenges consumers to face when enrolling in private insurance, and methods that empower the consumers. How to Prevent Abuses and Inefficiencies in Third Party Payments Abuse and inefficiencies caused by third-party payments or payers are causing large scale issues for the health system, making it the priority issue that needs immediate action. Inappropriate payments result due to errors, abuse, and fraud, which include charging for service not completed, unwarranted extra services, or even patients sharing their health insurance information with others. These payments include unauthorized benefits due to intentional deception to maintain the inflow of funds from the organization like the hospitals, laboratories, nursing homes, clinician offices, among others. About 10 percent of the healthcare system's expenditure wasted on fraud and
THE FLOW OF FUNDS WITHIN AN ORGANIZATION 3 abuse. U.S. laws it is a crime to commit fraudulent behaviors regardless of whether it is intentional or not (Joudaki et al., .2015).

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