Blue Cross and Blue Shield Association

organizational climate because our coworkers uplift each other in hopes of bettering ourselves as well as our patients. In addition, we have a staff of six core people that consist of the owner, director, billing specialist, and case managers. Phylandria Hudson is the owner and the only LCSW within the company, so she does most of the paperwork as well as teaching the case managers different techniques in counseling. The director is Cynthia Robinson, and she is not really in the office as much because her focus is bringing in more clients. She does many marketing events around the area to help with bringing in more patients. Denita Johnson is the billing specialist and by being a behavioral health, we are talking all insurances such as Blue Cross Blue Shield, Medicaid, etc. After the two case manager that go out into the field come back, she then punches the codes so that we can bill whoever was seen that day. She does the same for the patients who are in the facility. Furthermore with being a case manager the primary goal is to help the patients achieve their objectives and to cope with their mental issues. Each case manager has about 80 cases to do within a two-month period within the Hinds County region. We have to go out into the field and meet with our patients at their home so that can talk with us about what has been going on since the last time we have spoken. Mental and health care providers also need an individual awareness of professional boundary crossings and…

Since the first establishment of the United States government, Americans has been brainwashed to believe the power to do what is good for the people. A large percentage of Americans would agree that the government have control of everyone’s life. Some people would ask the numerous questions that would make people really think. What kind of things should the government have control over? How much authority should the government be given? In my opinion, I believe that the government should have…

variety of payers on a state, federal and private pay level. An example of one of the types of reimbursements used at Memorial Sloan-Kettering (MSK) is “Fee-for- service reimbursement”. With this type of reimbursement providers receive payment for each service that is made (Hagland). There are advantages to this type of method such as independence to policy holders and some disadvantages are the risk of uncertainty and high copays and deductibles for patients. Examples of a “fee-for-service”…

abilities. Joy finds her biggest challenges working within the political divisions of corporate society. Finding approvals for budgets from a variety of divisions including HR, Medical, and others. Joy feels that one of her greatest achievements is, initiating a Fit for Life program that incorporates a mini grant that funded electronics health monitoring and tracking devices known as Fitbits to Council employees. This allowed participants to set and track goals, monitor success and…

Public and Private Healthcare According to Institute of Medicine (IOM), healthcare costs and quality issues have risen in the last ten years (Linsley, & Morton, 2014). Healthcare is provided through both public and private health agencies. Public healthcare agencies are provided by the government such as Medicaid. Private healthcare agencies are non-government providers such as Blue Cross Blue Shield (BCBS). Both agencies have set rules of addressing cost and quality of care to the community.…

care is quite distinct from those used in other developed nations; most other developed countries have a system that involves a set of services to which every citizen is entitled, which is paid for by the central government” (Kovner, 2015, p. 233). There are three major ways that the health services system is financed: private insurance, government insurance and publicly financed programs, and out-of-pockets financing. Private insurance financing and coverage varies depending on who is paying…

The American healthcare industry is a fluid industry. The healthcare industry is continuously changing, sometimes these changes are good and sometimes they are bad. These changes can be as large as enacting a federal law requiring all Americans to have a form of health insurance, or as small as a multibillion-dollar company giving out grants in order to help those who lack sufficient health insurance. One of these recent changes in particular has thrown the whole system into the spot light and…

I decided to do the last reflection paper on Sick Around America because I am curious to why there still is problem of paying for affordable health when so many people in the US continue to suffer and die because of it. I would just have imagined by this day and time that someone would have come to a proposed solution so that everyone could afford some type of medical care for problems that they suffer from. It just put me at awe when these insurance companies like Blue Cross Blue Shield do…

patient’s discharge occupational therapy is scheduled for Mr. Quinn in his home called home health serves (University Hospital, 2016). Blue Cross Blue Shield of Georgia PPO Vs. Georgia Board of Regents State Benefit Health Plan HMO. Blue Cross Blue Shield of Georgia allows patients to go to any doctor they choose without referral, and allows the patient to choose the level of coverage needed (Blue Cross Blue Shield, 2016). The Georgia Board of Regents State Benefit Health Plan HMO is offered to…

Senior Healthcare’s CRM database. The CRM database is where all the client information is stored on the computer. Any document that is placed into a client file that is to be filed, must also be uploaded and placed in the appropriate CRM client folder. I think that during this internship I have also been the go to for any questions about computers and/or the VOIP phone system. I had never heard of the phone system but I have had to learn about it in order to be the expert, to answer new agent’s…