Third-Party Payment Systems and the Operational and Strategic Planning in Healthcare

Running Head: Third party payment system and the operational and strategic planning in healthcare
Third-Party Payment Systems and the Operational and Strategic
Planning in Healthcare

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Third party payment system and the operational and strategic planning in healthcare
Table of Contents
IV. Third party payment system.................................................................................................3
a. Healthcare system reimbursement......................................................................................3
b. Reporting requirements......................................................................................................3
c. Compliance standards and financial principles..................................................................3
d. Reimbursement methods....................................................................................................3
V. Operational and strategic planning in healthcare..................................................................4
a. Pay for performance incentives..........................................................................................4
b. Operational performance measures....................................................................................4
c. Teamwork and strategic planning.......................................................................................4
d. Communicating strategic planning.....................................................................................5
e. Financial and reimbursement strategies..............................................................................5
Reference list..............................................................................................................................6

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Third party payment system and the operational and strategic planning in healthcare
IV. Third party payment system
a. Healthcare system reimbursement
Third party models for the impact they pay includes fess for service, health maintenance
organization, Independent practice association, managed care, Point of service, preferred
provider organisation. These models cater to authorize the reimbursement policies through a
significant plan that helps to impose on understanding the impact on healthcare system
reimbursement.
The fee for service payment system also caters to reflect a positive analysis for the patient
during the service. The models stated above have their individual plans to guide patients
while paying the health sector bills. The managed care model sets an agenda to the
reimbursement policies that can be established within a definite patient service. The
respective understanding of point of service and preferred provider in healthcare
reimbursement resolves the idea of repayment assistance with a lesser issues within the
healthcare setup. The models also reflect in creating an impact on the medical policies. In
fact, the reimbursement is directly related to grow with a constant understanding of
establishing the categorical replacement of the total amount paid by the service user.
Healthcare system reimbursement indicates the repayment system incurred within a
healthcare organization during or after a treatment procedure is conducted. As per Diaby &
Goeree (2014), insurance providers or government payers are entitled to pay treatment
amounts. However, this also depends on the policy taken up by the respective service user.
On such scenarios of entitlement, the financial institutions need the entire documentation of
on spot payment to reimburse respective service user. Third party payer model includes
insurance companies, employers, government agencies and others that includes in the list of
reimburse panels.
b. Reporting requirements
Third party payer payment system should report in chronological order as it includes third
party payers such as insurance companies, government agencies, employers and others.
According to Dombret et al. (2016), opportunities can identify by their system of payment
and they can develop by considering different payment options. In case of reimbursement, the
primary requirements include documented papers reflecting the payment made by the service