Medical Business Operations: Actualization, Case study homework help (3-4 pages)

1. Introduction (25%) Provide a
brief synopsis of the meaning (not a description) of each Chapter and articles
you read, in your own words that will apply to the case study presented.

2. Your Critique (50%): Case Study

Business Operations: Actualization

The Superior Care Health Group (SCHG) has been experiencing a large percentage
of billing rejections from various third-party payers. Although there are many
reasons for the claim rejection, the main problem is Inaccurate billing codes,
specifically those as ICD-10 codes.

office manager, Mr. James Hopkins MHSA, who is new to SCHG, suspect that the
problem is with the group’s old billing software. When an office associate is
given medical chart information to code, the software only provides a list of
potential ICD-10 codes when the physician’s diagnosis is keyed and entered into
the system. It is up to the office associate to make the determination between
diagnosis that are very similar and difficult to differentiate.  Mr. Hopkins knows that newer software can
make the code differentiation more automatic and accurate.


  1. How and where Mr. Hopkin can start with
    this project?

  2. How can Mr. Hopkins address these

  3. Where should he start his research?

  4. Once all change are done, which ones
    will be future results? Describe and explain all of them in detail.

3. Conclusion (15%)

Briefly summarize your thoughts &
conclusion to your critique of the case study and provide a possible outcome
for the Health Care Center.  How did
these articles and Chapters influence your opinions about Health Care Computer

will be based on how clearly you respond to the above, in particular:

a) The
clarity with which you critique the case study;

b) The
depth, scope, and organization of your paper; and,

c) Your
conclusions, including a description of the impact of these Case study on any
Health Care Setting, Law and Legislation.


Expert Solution Preview


After reading Chapter 7 and Chapter 8, as well as the health guide, it is clear that the use of technology in healthcare has rapidly increased over the years, with electronic health records being adopted widely. The chapters discuss the importance of defining clear goals, planning, and training staff for successful implementation of electronic health records. The health guide provides an overview of the potential benefits and drawbacks in using electronic health records.

2. Your Critique:

Mr. Hopkins can start with this project by conducting a thorough assessment of the current billing software and gathering information on newer software options that offer automatic and accurate code differentiation. He can address these issues by gaining insight from physicians and office associates, integrating new software solutions, and providing training to staff to ensure accuracy in ICD-10 code selections. He can start his research by attending healthcare technology conferences, consulting with vendors of medical software, and researching peer-reviewed articles published related to medical billing software. Once all changes are made, the future results will include a decrease in claim rejection and an increase in timely payments, improving overall financial health for the Health Care Center.

3. Conclusion:

In conclusion, the case study highlights the importance of utilizing updated technology in healthcare facilities. Mr. Hopkins can address the issues and alleviate the deficiencies of the old billing software by researching and implementing newer software and providing staff with adequate training. The application of these articles and chapters has reinforced the need for careful planning and training when utilizing healthcare technology.

The impact of this case study on health care setting, law, and legislation lies in its ability to highlight the need for modernized software and technological advances, leading to better patient outcomes and more efficient healthcare systems. By utilizing electronic health records, medical billing and coding become precise and minimize errors, decreasing any legal or liability issues stemming from inaccurate coding.

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