Health Services Coordinators (HSCs) Orientation Manual

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect.
A. Provide a title page, table of contents, and chapter headings as follows for the orientation manual described in the scenario:
• Chapter 1: Medicare/Medicaid
• Chapter 2: HMO/PPO Plans
• Chapter 3: Role of the HSC
• Chapter 4: Community Resources and Programs
Chapter 1: Medicare/Medicaid
B. Discuss the Medicare reimbursement process by doing the following:
1. Describe three Medicare reimbursement requirements.
2. Describe three methods that are in place to ensure your facility remains compliant with Medicare reimbursement requirements.
3. Describe three Medicare reimbursement regulations.
C. Discuss the Medicaid reimbursement process by doing the following:
1. Describe three Medicaid reimbursement requirements.
2. Describe three methods that are in place to ensure your facility remains compliant with Medicaid reimbursement requirements.
3. Describe three Medicaid reimbursement regulations.
Chapter 2: HMO/PPO Plans
D. Choose an HMO or PPO plan, and discuss compliance regulations by doing the following:
1. Describe standard mechanisms for an appeal for denial of coverage.
2. Discuss reimbursement limitations.
Chapter 3: Role of the HSC
E. Discuss the HSC’s role across practice settings by doing the following:
1. Describe four job tasks for the HSC.
2. Describe how the job tasks from part E1 apply to working with clients at risk for each of the five domains of the SDOHs.
3. Discuss three ethical dilemmas that may be encountered in the HSC role.
a. Justify how each of the 3 examples could be considered ethical dilemmas.
Chapter 4: Community Resources and Programs
F. Discuss community resources and programs by doing the following:
1. Discuss how three existing community resources in your area could help mitigate the negative effects or enhance the positive effects of one SDOH.
2. Describe two community resources that are needed in your area to help mitigate the negative effects or enhance the positive effects of the SDOH from part F1.
a. Explain two reasons why the community resources from part F2 could mitigate the negative effects of the SDOH in your area.
b. Explain two reasons why they could enhance the positive effects of the SDOH in your area.
G. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
H. Demonstrate professional communication in the content and presentation of your submission.