Driver’s License


1) We are familiar with licensing. To be able to legitimately drive a car in the United States, we have to have a driver’s license. Some of you omay also be certified, meaning you have proven yourself to have special skills in a specific area. We hear the term “accreditation” most often in regard to schools. You may have been told, “Make sure the school you attend is accredited.” Healthcare facilities also come under regulations to be licensed, certified, and accredited in order to legitimately operate. Holding these credentials ensures to the public that the healthcare facility provides quality services.

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Differentiate between licensure, certification, and accreditation as it applies to  healthcare facilities.

Include the following in the discussion:

1) Define each of the terms as they apply to healthcare facilities.

2) Are there differences and similarities between the three terms?

3) Discuss the impact and value of each of these three regulations on operating systems within the healthcare facility, such as health information systems.

4) How would you known if the healthcare facility held any of these designations?

5) Cite any references.

6) Proper grammar, sentence structure, and spelling is required. Use your own words. Copying and pasting is not allowed.

2) In this discussion, you are to review the following ethical and legal dilemma:

A solo-practice provider has been practicing in a specific area for 19 years. At 20 years, the staff, several of whom have been with the doctor since the start, can collect retirement through a contracted vendor. However, due to a diminishing of insurance reimbursement, the doctor cannot keep the doors open any longer. The provider realizes that both her and her employees are unlikely to find employment that will provide for any means of financial security in their aging years. Attempts at marketing and attracting additional clients have been unsuccessful as a result of managed care contracts and preferred provider arrangements that have gone to hospital-based physicians. There are no other options, save one. The provider knows that if she upcodes the visits and charges more, she can keep her doors open and retire in a short 12 months.

In your main discussion post, discuss the current dilemma from the perspective of the provider and from the perspective of the staff. Are there any gray areas to this dilemma? If so, can you understand why a provider would be tempted to upcode? Unfortunately, this dilemma is happening across America. In replying to your peers, evaluate their positions on this dilemma. Did you find common ground? (1 page)


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