Mcleod Regional Medical Center Case Study

McLeod Regional Medical Center is a non-for-profit hospital organization that has provided medical excellence since 1906 from the Midlands to the Coastal region of North and South Carolina. McLeod Health’s network consist of seven hospitals, over 750 physicians, and more than 8500 employees. The segment of the organization that this will focus on is the business office or patient accounting department of the organization. This department includes the services of billing, coding, refunds, appeals, etc. This is the department that ensures that billing and coding are done legitimately that produces the income of the organization.
SWOT Analysis This section will break down the SWOT (strength, weakness, opportunity, threat) of the business
A patient’s experience comes from more than just what happens during the time of service. The experience is continued after when they are trying to get services paid by insurance or their self. A common misinterpretation of understanding why an insurance may pay or may not pay contributes to this. The billing department being able to explain these questions to a patient helps the satisfaction of the patient. According to the public opinion survey conducted by Copatient shows that 72% of Americans are confused by medical bills (Understanding Your Medical Bills, n.d.). Internal process consists of making sure that all components of billing and coding is done correctly in the business office. This can be measured by performing internal audits on department coders to ensure accuracy. Monitoring A/R reports from denials, adjustments, and appeals will ensure proper A/R follow up is being conducted. The overall hospital organization have compliance department that also audits to ensure correct coding and billing is being done. Performing these audit as an individual department along with organizational wide ensures state and federal regulations are being