Expert answer:Case Study
Answer & Explanation:Hello there, I am doing my internship this semester at Physician Supports Service ( medical billing company ), I am attaching a sample from previous student’s work you need to change it to your own words . , YOU MUST follow these instructions :Case Study Paper:The written, typed case study should be 7-10 pages long, double-spaced, 10 or 12 point font with 1 inch margins. . The Case Study will be submitted as part of the Assessment Portfolio. Your internship project could be, but may not necessarily be, a focal point of this case study. The case study should have the following components:1. Background statement. What are the organization’s mission, goals and objectives? Discuss organizational characteristics e.g. size, ownership, profit-status and current financial position ( You may need to locate their balance sheet or annual report to get this information). What populations does the organization serve? Who are their key stakeholders and customers? What are some key challenges posed by the environment and industry? What is its competitive position in the market place including market share, market penetration etc. Describe the leadership and organization, setting, situation, who is involved, who decides what, etc.2. Identify your role. Describe what department(s) you worked in, who your preceptor was and the preceptor’s role in the organization. Where did your department and preceptor and YOU fit into the overall organization?3. Identification of diversity and other issues (culture, finance, location, competition etc.) that are impacting or likely to impact this case. How do matters of race, color, ethnicity, gender, sexual orientation, age, national origin, religion, and/or disability appear in this case and what impact might they have on this case? Be sure to include diversity issues in each section of the case study, identifying how they relate to Major problems and secondary issues, Organizational strengths and weaknesses, Alternatives and Resolutions, and Evaluation.4. Major problems/work place challenge and secondary issues. What major problems and secondary issues did the organization and/or department face that you observed during your internship? What were the real issues? Analyze the causes and effect utilizing a framework or tool learned in the class or at your internship. What is your analysis of the situation? Think about the underlying motivators. Fully explain your reasoning.5. Organizational strengths and weaknesses. What are the organization’s or department’s strengths and weaknesses? What strengths do they bring to the marketplace? What weaknesses do they need to address?6. Alternatives and Resolution. What alternatives does the organization or department have available to them? What feasible strategies would you recommend? State what should be done–why, how, and by whom. Specify the actions, steps and recommendations.7. Evaluation. What evaluation plan would you have them put in place to enable them to assess if they are meeting their goals?case_study_sample_need_to_be_in_your_own_words__.docx
case_study_sample_need_to_be_in_your_own_words__.docx
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Case Study
Background Statement.
Physician Support Services, LLC is customer focused medical billing company that
distinguishes itself from its competitors because they believe in collaborating with their clients to
assist them in identifying their true requirements, desires, expectations and adherence to all
regulatory requirements. Physician Support Services objective is to provide the highest quality of
customer service by integrating our clients’ missions, values and principles into our management
solutions.
Physician Support Services mission is that “We are the first choice of all clients desiring
ethical and competent medical billing and consultative services.” PSS fulfills their mission by
incorporating their “Guiding Principles” throughout all services provided to their clients. The
“Guiding Principles” are listen to our clients by helping them identify their needs, wants, and
expectations; maintain our integrity by not engaging a client that is unwilling to comply with
regulatory requirements; work as a team by recognizing and reward team performance over
individual performance; and be responsive to the client by remember the client is the reason why
we perform our work.
Physician Support Services goals are providing client support, leaving a positive imprint
with their clients, and more importantly allowing the physicians to have the ability to focus on
their patients and not constantly worry about the business side of the practice. Not only are all
these accomplishing goals of PSS but also characteristics that set apart from other competitors in
the local healthcare market.
The population this organization serves is physicians that are willing to be a contract with
Physician Support Services. Their customers are patients of the physicians. PSS essentially does
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billing for physicians and their patients, of all accepting insurances, of medical practices and
hospitals. Their position in the marketplace is very competitive. Surrounding the Baltimore
region there are about 97 and of those 97, 91 of them are in Towson, MD. Though there is a lot
of surrounding competition within the healthcare marketplace there are many distinguishing
factors of PSS that sets them aside from all the other medical billing offices. A major factor is
the culture and methodology of PSS team functions on a daily basis is by assisting physicians of
their healthcare practices and increasing their revenue by processing claims within 24 hours of
received date, direct phone availability to not only the physicians but their patients as well, and
dedication of the longevity employees.
PSS is a small growing home-like office. There is conveniently a full-fledged kitchen in
the back to store food in the refrigerator and to heat food in the microwave. There is commonly
shared Tupperware to use in case if an employee forgets a utensil. With beautiful spring colored
table clothes, employees can sit together, chat around, and share food during lunch break. Most
places lunch break is 30 minutes but at PSS it is 1 hour which gives enough time to squeeze in a
nap, make personal phone calls, and even run out to get something. PSS office setting and
situation makes the employees feel the office is a home away from home.
Organizational Chart
Charles Zorn
CEO
Kathy Sanzone
CFO
Tarsha/TL
Charge Entry
Tiffany, Kelly,
Cathy
Kristin/TL
DCH
Denise/TL
COS/Mt. W
Michelle/TL
COS
Tyra, Kenneth, Lori
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Ruth
Receptionist
Lisa
Accounting Assistant
Mary
Heart Associates
Ralph
IT
Elisa &
Adrienne
Lock Box
Identify Your Role.
In PSS, there are four departments. The four departments are registration and charge
entry, lockbox, follow-up, and payment posting. Most time I worked in the charge entry
department. My preceptor was Charles Zorn. My preceptor’s role in the organization is Chief
Executive Officer. My department, registration and charge entry, plays a huge role in the overall
organization because through registration and charge entry team register all new patients and
create an account for them in the Navigator system then insert the patient’s information include :
Patient name, address, Phone #, SSN#, Birth date, M #, and the information of the guarantor.
Also if patient has any changes such as: address, insurance, and referrals+ authorizations. Theses
need to be editing as well. Registration is the first gate for the organization. Also, the department
is responsible to open charges tickets that have not been paid, we charge the patient for seeing
the doctor (bills) for what ever reason the charge is not paid either insurance company or patient
has not paid (self payments).
My preceptor, Mr. Zorn, fits in the entire organization because all the employees work
progress and status is reported to him by his assistant Kathy Sanzone. Mostly all the employees
report to Kathy but if any serious issues in which Kathy can’t handle then my preceptor will take
charge.
I personally fit in all the departments in the overall organization. I helped in all the
departments when necessary but mostly day to day I was with the follow-up team. As an intern
for the follow-up department my responsibilities were to write off claims that were past the filing
date limit, call insurance companies for claim statuses, understand denial claims returns,
resubmit claims after fixing denial issues, and update patient’s account for more recent claim
status updates.
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Identification of Diversity Issues.
Matters of race, color, ethnicity, gender, sexual orientation, age, national origin, religion,
and/or disability does not impact the case or apply for this internship. PSS is mostly womenstaffed except Ralph, IT Tech, and Charles Zorn, CEO. There are no diversity issues at Physician
Support Services or diversity issues related to the case study, major problems and secondary
issues.
Major Problems and Secondary Issues.
Throughout my internship, I was able to work and investigate in a project that meets with one of
the goals that I already set and adjusted with my preceptor, the goal was investigate the rules and
regulation concerning PQRS (Physician Quality Report System) reporting. Determines structure
for reporting in Heart associates information Company; and track each patient’s information on
spreadsheet. According to the CMS.gov center for Medicare and Medicaid service website “The
Physician Quality Reporting System (PQRS) is a quality reporting program that encourages
individual eligible professionals (EPs) and group practices to report information on the quality of
care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the
quality of care they provide to their patients, helping to ensure that patients get the right care at
the right time”.
By reporting on PQRS quality measures, individual EPs and group practices can also quantify
how often they are meeting a particular quality metric. Beginning in 2015, the program will
apply a negative payment adjustment to individual EPs and PQRS group practices who did not
satisfactorily report data on quality measures for Medicare Part B Physician Fee Schedule
(MPFS) covered professional services in 2013. Those who report satisfactorily for the 2015
program year will avoid the 2017 PQRS negative payment adjustment.
For the project, I had to investigate tow Physician offices by looking to their PQRS measures
sheet for two types of diseases Heart failure and Coronary artery ,then insert the information
such as : Patient name, age, gander, date of birth, provider name, insurance company and
number, individual NPI, patient ID, PQRS code, CPT code, diagnostic code in Excel sheet
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Organizational Strengths and Weaknesses. You need to come up with little bit of different
strength and weakness and paphrase the words
Some of the organizational strengths are communication and hardworking strong teams.
Since the office space is small, all the employees have good communication among themselves.
The office setting is in such a way there is open communication between all the employees. The
administration staff constantly walks around asking for updates and are available anytime for
questions and concerns.
The teams are very hardworking and solid. Each team has their own cubicle for easy
accessibility for documents and communication. At the end of each month each team has to
submit all the charges and claims in for that month; it is a very crucial time for PSS employees.
Especially during that time, all the employees helped each other. That showed me many things
about the organization and the employees themselves. I learned all the employees think of
themselves as “one team” and not “individual employee,” and helpful to one another. Being able
to come to work knowing that your co-workers are there for you and PSS is one big family is
very comforting versus everybody doing their own job in a non-friendly environment.
Because all the employees work together as one big team, the physicians are aware that
their charges are being paid in a timely manner. That is a huge strength to the marketplace.
Through word of mouth physicians can talk to one another and recommend PSS as their billing
choice because of speedy payments and reimbursements.
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Some of the weaknesses at PSS are having only two printers/scanners and attracting new
physicians. Having only two printers/scanners can be challenging at times especially if one
machine isn’t working. Everyday scanning the batches to process them into the EHR system and
printing HCFA to submit the claims, a reliable printer/scanner is very important to a billing
office. Since I’ve been here one of the printer/scanner has had issues 3 times. All the employees
were scanning and printing to the other printer which caused some papers missing while
scanning and another employee picking up their co-workers print outs. Having another
printer/scanner may be beneficial as to saving paper by not reprinting missing material and time
as to depending only on one printer when the other one is down.
Another weakness I recognized is when I typed in google “Physician Support Services
LLC Towson” I saw many links but no reviews about them.
Nowadays social media plays a huge role in networking. Possibly having physicians write
reviews about their positive experience with PSS can help bring more awareness for other
physicians to consider PSS as their billing choice. When people google for goods and services,
they usually read the reviews and base their decision off of that. With many billing companies in
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the marketplace, having positive reviews will not hurt the company but only open the eyes of
other upcoming physicians.
Alternatives and Resolution.
I stated all of the possible alternatives and resolutions in each section.
Evaluation. Do your evaluation for this company please
http://www.medicalbillingcareer.org/medical-billing-coding/
the link above might help you !!!
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