Examining Financial Resource Management for Effective Fund Management
Within the healthcare environment there are many factors that need to be considered when examining organizational finances and making financial decisions that will have both short- and long-term effects on a healthcare organization. There are external agencies such as the federal or state government, which may set rate limits that impact revenues. Also, there are outside forces such as marketing structures and competition that influence pricing of healthcare services. Healthcare professionals who oversee budgets and help to make financial decisions need an overall understanding of the forces shaping this environment.
1. Explain how financial statements are reviewed for an organization to determine its profitability and risk.
2. Discuss factors that influence the financial viability of a healthcare organization.
C. Discuss how each of the following Fraud & Abuse regulations impact the financial decisions made by a healthcare organization: • Anti-Kickback Statute • False Claims Act
1. Discuss the importance of the Anti-Kickback Statute to healthcare providers.
2. Discuss the importance of the False Claims Act to healthcare providers.
D. Analyze the factors that influence healthcare pricing in healthcare organizations.
E. Explain the financial management control process, including budgeting and financial planning.
F. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
G. Demonstrate professional communication in the content and presentation of your submission.
Examining Financial Resource Management
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Examining Financial Resource Management
Financial resource management is a key element in the healthcare organization. No reliable healthcare organization can work without managing its funds, and effective resource management allows a healthcare organization to meet its obligations and strategic goals. The paper examines financial resource management by addressing key elements such as billing, profitability, laws, pricing, and communication.
A. Coding and Billing Cycle
Billing cycle and coding processes have a significant impact on revenue cycles. The billing cycle shows effective maintenance and correct chargemaster, which requires annual and daily updates depending on the charges. Therefore, the billing cycle is necessary for the chargemaster, which is significant for the revenue cycle since it promotes accurate insurance reimbursement and avoids errors in the healthcare organization. Besides, coding is significant for the revenue cycle since all the patients' information is coded using different codes such as soft and CPT codes (Silverman, 2020). Coding is vital for the revenue cycle since whenever the expert encounters an error, it adversely impacts organizational reimbursement. Some issues with insurance claims may also be noted. Therefore, billing cycle and codding are significant for revenue cycles.
B. Financial Condition
Evaluating a healthcare organization's financial condition is a key process that every expert must understand. It is based on the future and current financial status of the healthcare organization. It is achieved by determining whether the available finances can adequately meet the organizational goals and objectives and any possible financial alteration. It also involves analyzing how specific medical covers benefit the organization and the long-term impacts of their withdrawal. It is also done by analyzing its records, funds, and suppliers. Suppliers play a key role in organizational profitability due to the quality and pricing of the medical resources (Silverman, 2020). Therefore, evaluating all the healthcare organizational resources is vital for evaluating and understanding its financial stability and position.
B1. Profitability and Risks
Reviewing financial statements in the healthcare organization is vital for determining risks and profitability. The major financial statements that should be reviewed include the balance sheet, statement of cash flow, and statement of operations. Balance sheets contain equity, liabilities, and assets; thus, it shows a higher risk to the healthcare organization when liabilities are more than assets. Statement of operations indicates investment incomes, medical sales, grants, and reimbursement. The financial analyst must note all the elements and whether they generate profits or losses. The cash flow statement is also vital since it determines whether a consistent flow of funds in the healthcare organization (Krylov, 2018). Therefore, during the analysis of the financial statements, the major aspect of determining is the expenses and the revenue. Whenever any financial statement shows more expenses than the in...
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