NUR 621 Healthcare Reimbursement Training Paper
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The purpose of this assignment is to discuss how different insurance providers reimburse health care organizations for services.
You are the nursing administrator at a community hospital providing a training for your unit directors.
Create a 12- to 14-slide PowerPoint Presentation (excluding the title and reference slides) addressing the following:
- Discuss how Medicare, Medicaid, and private insurance reimburse health care organizations.
- Describe the differences between cost, charge, and payment.
- Explain Diagnostic Related Groups (DRGs) and provide at least two examples.
- Discuss how insurance reimbursement affects private pay patients (those with no insurance).
Include at least 3 peer-reviewed resources.
Additionally, include a title side, reference slide, comprehensive speaker’s notes, and graphics that are relevant to the content, visually appealing, and placed appropriately.
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
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Healthcare Reimbursement Training – Rubric
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Rubric Criteria
Total100 points
Criterion | 1. Unsatisfactory | 2. Insufficient | 3. Approaching | 4. Acceptable | 5. Target |
---|---|---|---|---|---|
Medicare, Medicaid, and Private Insurance
Medicare, Medicaid, and Private Insurance |
0 points
Does not discuss how Medicare, Medicaid, and/or private insurance reimburse health care organizations. |
16 points
Unclearly discusses how Medicare, Medicaid, and private insurance reimburse health care organizations. |
17.6 points
Partially discusses how Medicare, Medicaid, and private insurance reimburse health care organizations. |
18.4 points
Clearly discusses how Medicare, Medicaid, and private insurance reimburse health care organizations. |
20 points
Thoroughly discusses how Medicare, Medicaid, and private insurance reimburse health care organizations. |
Cost, Charge, and Payment
Cost, Charge, and Payment |
0 points
Does not describe the differences between cost, charge, and/or payment. |
16 points
Incomprehensibly describes the differences between cost, charge, and payment. |
17.6 points
Somewhat describes the differences between cost, charge, and payment. |
18.4 points
Succinctly describes the differences between cost, charge, and payment. |
20 points
Comprehensively describes the differences between cost, charge, and payment. |
Diagnostic Related Groups
Diagnostic Related Groups |
0 points
Does not explain Diagnostic Related Groups. |
16 points
Ineffectively explains Diagnostic Related Groups with an example. |
17.6 points
Broadly explains Diagnostic Related Groups with at least two examples. |
18.4 points
Effectively explains Diagnostic Related Groups with at least two examples. |
20 points
Expertly explains Diagnostic Related Groups with at least two examples. |
The Effects of Insurance Reimbursement on Private Pay Patients
The Effects of Insurance Reimbursement on Private Pay Patients |
0 points
Does not discuss how insurance reimbursement affects private pay patients. |
16 points
Inaccurately discusses how insurance reimbursement affects private pay patients. |
17.6 points
Ambiguously discusses how insurance reimbursement affects private pay patients. |
18.4 points
Accurately discusses how insurance reimbursement affects private pay patients. |
20 points
Insightfully discusses how insurance reimbursement affects private pay patients. |
Speaker Notes
Speaker Notes |
0 points
Speaker notes are not included. |
4 points
Speaker notes are incomplete or incorrect. |
4.4 points
Speaker notes are included but lack explanation and relevant supporting details. |
4.6 points
Speaker notes are complete and include explanation and relevant supporting details. |
5 points
Speaker notes are thorough and include substantial explanation and relevant supporting details. |
Presentation of Content
Presentation of Content |
0 points
The content lacks a clear point of view and logical sequence of information. Presentation includes little persuasive information. Sequencing of ideas is unclear. |
4 points
The content is vague in conveying a point of view and does not create a strong sense of purpose. Presentation includes some persuasive information. |
4.4 points
The presentation slides are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other. |
4.6 points
The content is written with a logical progression of ideas and supporting information, exhibiting a unity, coherence, and cohesiveness. Presentation includes persuasive information from reliable sources. |
5 points
The content is written clearly and concisely. Ideas universally progress and relate to each other. The project includes motivating questions and advanced organizers. The project gives the audience a clear sense of the main idea. |
Mechanics of Writing
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. |
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. |
4 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. |
4.4 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. |
4.6 points
Few mechanical errors are present. Suitable language choice and sentence structure are used. |
5 points
No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout. |
Format/Documentation
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline. |
0 points
Appropriate format is not used. No documentation of sources is provided. |
4 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident. |
4.4 points
Appropriate format and documentation are used, although there are some obvious errors. |
4.6 points
Appropriate format and documentation are used, with only minor errors. |
5 points
No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated. |
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