HIM 660 Module 8 Journal Example

Reviewed by Delia Ravenscroft, MSN, RN

This HIM 660 Module 8 Journal sample reflects on what denied claims mean for patients rather than only for a hospital's revenue. It was written for SNHU HIM 660 (HIM-660), where the Module Eight journal turns MS Health Information Management learners toward the human and ethical side of money decisions. The composite HIM director at a two-hospital system near Charleston, West Virginia, has spent weeks treating denials as a write-off figure in a financial model. Then a patient complaint arrives: a retired coal miner billed $1,840 for an MRI his insurer refused because an authorization was never obtained. The entry connects that letter to research on who carries the burden of denials and medical debt, questions how the department's plan counts success and ends with a decision to add a patient measure to the denial prevention work.

CourseHIM 660 HIM Strategic Planning and Financial Management
ModuleModule 8
Paper typegraduate journal entry on the patient side of denied claims
LengthAbout 370 words, 3 pages
FormatAPA 7 student paper
SchoolSouthern New Hampshire University
ProgramMS Health Information Management
UpdatedOctober 2026

Free sample paper for HIM 660 Module 8

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Module Eight Journal

The Letter From Nitro

For three weeks I have treated denials as a number: $2.9 million in write-offs, a 25% reduction target, $725,000 a year in net present value. This week our patient advocate forwarded a handwritten letter from a retired miner in Nitro. His insurer denied an MRI because no one obtained prior authorization, and he received a bill for $1,840. He wrote that he had done everything he was told.

What this page is doingThe entry contrasts a model with a person.
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His letter made me look again at what our write-off line measures. When a claim is denied for our error, the hospital often writes it off, and that is the cost I have been modeling. But sometimes the balance is billed to the patient first, and whether it is ever corrected depends on whether someone pushes back. A national study of denial corrections found that households earning below $50,000 a year were the least likely to see a denied claim challenged, and that patients from historically disadvantaged groups carried the largest burdens (Horný et al., 2025). Many of our patients fit that description. A denial the hospital never fights can become a bill the patient never should have received.

Kluender et al. (2021) estimated that about 18% of people carried medical debt in collections by mid-2020, and the average balance was highest in Southern states and low-income zip codes. Our valley is both. I also remembered Tseng et al. (2018), who showed how much time billing work consumes. That time is real for patients too: phone calls, letters and confusion that a missing authorization creates, none of which appears in my net present value.

I do not think the financial model is wrong. It is incomplete. It counts what the system loses and not what the patient pays when our process fails him.

What this page is doingResearch widens the frame from revenue to patient burden.
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So I am changing the denial plan. Every denial caused by our own process, such as a missing authorization or a coding error, will be held from patient billing until it is reviewed, and the denial team will report a new measure: patient balances created by our errors and how quickly they are reversed. I called the miner myself. His bill has been withdrawn, and his letter is now in my planning folder.

What this page is doingThe writer commits to a concrete change.
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References

Horný, M., Yu, O., & Hoagland, A. (2025). Claim denials: Low-income patients from disadvantaged racial and ethnic groups experienced the largest burdens. Health Affairs, 44(6), 707-715. https://doi.org/10.1377/hlthaff.2024.01277

Kluender, R., Mahoney, N., Wong, F., & Yin, W. (2021). Medical debt in the US, 2009-2020. JAMA, 326(3), 250-256. https://doi.org/10.1001/jama.2021.8694

Tseng, P., Kaplan, R. S., Richman, B. D., Shah, M. A., & Schulman, K. A. (2018). Administrative costs associated with physician billing and insurance-related activities at an academic health care system. JAMA, 319(7), 691-697. https://doi.org/10.1001/jama.2017.19148

What the HIM 660 Module 8 instructions ask for

Module Eight of HIM 660 asks for a reflective journal on the human or ethical side of financial planning. The entry is usually about a page, written in your own voice, with a source or two in APA 7 where research sharpens your thinking. Choose a moment when a financial measure met a real person, such as a patient affected by a denial, a coder affected by a staffing decision or a clinician affected by a documentation query. Describe it plainly. Reflect on what your financial analysis counts and what it leaves out, using evidence where it helps. Consider fairness and who carries the cost when processes fail. Close with a specific change you will make to your plan or practice, stated so that someone could check it.

How this HIM 660 Module 8 journal example is built

Kanawha Ridge Health's director has modeled $2.9 million in denial write-offs when a retired miner's letter arrives about a $1,840 bill for a scan denied over a missing authorization. Horný and colleagues' finding that lower-income patients are least likely to have denials contested, and Kluender and colleagues' evidence of high medical debt in the South and poorer areas, show who bears the gap. Tseng and colleagues' billing time research reminds the writer that patients spend time too. The HIM 660 journal calls the model incomplete rather than wrong and commits to holding self-caused denials from patient bills, reporting patient balances created by errors and calling the miner, whose bill is withdrawn.

Where the HIM 660 Module 8 rubric puts the points

Journal entries in HIM 660 are generally graded on honest reflection anchored in a specific event, insight into the ethical or human dimension of a financial decision, use of research to deepen rather than replace reflection, awareness of the writer's own assumptions and a concrete change in plan or practice. Strong entries hold two views together, recognizing that financial analysis is necessary while showing what it misses. Graders value attention to fairness and to who bears costs, especially vulnerable patients. A change that can be measured, such as a new indicator, carries more weight than a resolution to be more mindful. A personal, professional voice and accurate APA 7 citations support higher ratings.

HIM 660 Module 8 help: the mistakes that cost points

HIM 660 journals tend to fall short when they stay abstract, criticize finance in general, summarize readings without reflection or close with a vague intention. Some also describe a patient in ways that could identify them; keep details composite or de-identified. If your module asks you to reflect on staffing decisions, physician relationships, budget cuts or ethical billing rather than denials, send the prompt with a moment from your own experience and the entry will be written around it. The more specific the moment, the stronger the reflection. Our HIM 660 journals pair a real event with research and end with a change someone could verify.

Get HIM 660 Module 8 written to your instructions

Send the HIM 660 Module 8 journal prompt and a moment when a financial decision touched a real person in your work or the course case. The entry will reflect honestly, use research to widen the view, weigh fairness and close with a specific change to your plan, returned in a day or two with no charge for your first. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.

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More HIM 660 papers and related MS Health Information Management samples

HIM 660 Module 8 questions, answered

Where can I find a free HIM 660 Module 8 Journal sample?

This page shows the full HIM 660 Module 8 journal, in which an HIM director reflects on a patient billed for a denied scan and adds a patient measure to the denial plan.

How do claim denials affect patients?

Some denied balances are billed to patients, and research shows lower-income patients are least likely to have denials contested, so they may pay for errors they did not cause.

What should a reflective journal in HIM 660 include?

A specific event, an honest look at what financial measures miss, research that widens the view, attention to fairness and a concrete change to plan or practice.

Can a journal entry use a real patient's story?

Use composite or de-identified details only, removing anything that could identify the patient, while keeping the situation specific enough to be meaningful.

What patient measure could a denial prevention plan use?

One option is the number and amount of patient balances created by the organization's own errors, along with how quickly they are reversed.