Legal Ethics, Patients Rights, and HIV AIDS

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RUNNINGHEAD: LEGAL ETHICS, PATIENTS’ RIGHTS, AND HIV/AIDS1Legal Ethics, Patients Rights, and HIV AIDSDiscuss the legal and ethical considerations surrounding patient claims denial, hospital staffing, andthe care of HIV/AIDS patients. In your response, include the key challenges in insurance claimdenials, the ethical responsibilities of healthcare providers in staffing, and the unique legalconsiderations when treating HIV/AIDS patients. Your answer should explore how hospitals canensure that claims are not denied unfairly and patients are treated with dignity and respect.Additionally, analyze the impact of legal requirements such as confidentiality and antitrust issuesrelated to HIV/AIDS care. Your answer should be at least 1,200 words in length.

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LEGAL ETHICS, PATIENTS’ RIGHTS, AND HIV/AIDS2Assignment 3 Legal Ethics, Patients Rights, and HIV AIDSAs the head health care administrator at USA Community Hospital, you are required to review compliance reportson issues relating to the ethical conduct of the professional staff at your hospital, patient review registries, andstandard procedures surrounding the ethical treatment of patients with HIV / AIDS. Intermittently, complaintssurface from patients with HIV / AIDS concerned with ethical treatment and denial of services.Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.Write a six to eight (6-8) page paper in which you:1. Devise a plan to investigate the validity of patients’ claims of denial of services. This plan should include, butnot be limited to, establishing mechanisms to address service denial claims, a human resources component, anda review of related policies and procedures.2. Analyze the primary way in which different staffing levels may play pivotal roles in upholding ethical conduct,including treating patients with dignity. Justify your position.3. Formulate a plan to relate the primary legal ramifications to the professional staff regarding ethical treatment ofthe hospital’s HIV / AIDS patients.4. Devise a community relations plan that tout’s the hospital’s unique ways of serving persons with HIV / AIDS,including a focus on de-stigmatizing those afflicted.Legal Ethics, Patients’ Rights, and HIV/AIDSStudent NameCourse NameInstructor NameDateLegal Ethics, Patients’ Rights, and HIV/AIDSPatient’s claim denial:There are various claims of the patients denied due to various reasons. Especially,after the Obamacare it gives more protection to the people as patients enrolled with the

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LEGAL ETHICS, PATIENTS’ RIGHTS, AND HIV/AIDS3Obamacare will not be denied with the insurance claim (Bartolone, 2014). There are variousprocess and procedures adopted by the insurance company to validate the claim.Following are the some of the common reason for rejecting the insurance claims:•Invalid POS.•Invalid age group.•Duplicate claim.•Invalid units.•Patient does not possess valid Target Pop•Daily limit has exceeded.•Authed units exceeded(Coastalcarenc.org, 2014).•Service not in provided claim.•Service is not authorized.•Incomplete or inaccurate insurance information.•Error in coding and omissions of diagnosis andprocedures.•Insufficient medical necessity(Brozak, 2013).It is essential in identifying the reasons for rejecting a claim of patient. From theabove-mentioned points, it is clear that the main reason for such rejection. In order to addressthese problems, it is essential to have more organized and devised structure so that patientsget benefit out of their insurance.Hospital must provide their best support to their patients in claiming their insurance.A hospital must essential possess a management team who will be in a position to coordinatebetween the patient and insurance company (Brozak, 2013). It will enable the hospital inproviding all the required information to the insurance company. By providing all therequired information in an appropriate manner, will reduce the chances of a claim gettingrejected.

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