Question

Topic: Describe the roles of technology, people, information, and organizational components in health care information systems.

The readings for this week discuss health care organizations and systems, including systems to support administration, billing and finance. For your Stage 1 assignment, you will describe the roles of people, technology, processes, organizational components, and data/information in the EHR system for the Midtown Family Clinic. For this discussion, you will practice explaining these roles as they relate to a billing system for a hospital.

  As regards a billing system for a hospital, describe the role of each of the following:

1. People – who are the people that use the billing system? What other people are affected by the billing system?
2. Organizational Components – what departments use the billing system? What other departments or outside organizations might be involved?
3. Processes – what activities (processes) are the users of the system engaged in? (please do not just say "billing"!)
4. Data/information – list 5 data elements or information items that are important in the billing system.
5. Technology – how does technology support the billing system? What are some expectations you have about how the technology performs?

Answer 1

People that uses the billing system are healthcare providers, the patient, and insurance companies/ third-party payer.

Other people that play apart in the billing system as well include; registration , nurses, secretaries, pharmacy, and ancillary departments- pathology/lab, physical, occupational or speech therapy.

Once a patient is received and the appropriate clinical departments render patient care the patient is discarded and the billing process begins. A patient may have charges for services and items are posted through the chargemaster. The Charge Description Master (CDM), Health Information Management Department (Medical Records), the billing department and Accounts Receivable (A/R) management all utilize the billing systems while the other departments such as pharmacy, emergency room add the mostof the information.

Outside organizations that may be involved could be some outside providers such as surgeons, radiologist, insurance companies and third-party billing companies

While the primary purpose of the data accumulated in the medical record may relate to clinical decision making, a substantial proportion of the information is linked to billing

The users of the billing systems are engaged in entering information pertaining to the time a patient is admitted until the patients leaves and is billed. From the financial perspective, three activities are especially important in the billing and collection process. The most important activity is insurance verification. If the patient has indicated that they have third-party insurance coverage, it is important to have this coverage verified by the payer. The patient may also have secondary coverage from another health plan. Verification of that coverage is also critical to accurate and timely billing. The critical piece of information to collect from the patient in this regard is their health plan identification number, which may sometimes be their social security number

Data/information – 5 data elements or information items that are important in the billing system.

1.Patient Information Name (First and Last), Date of Birth, Gender

2.Address

3.Insurance Information (Primary and Secondary)

4.SSN (Social Security Number)

5.Admission and Discharge DateTechnology

The role of technology in supporting the Biling system is -

1. Technology Helps to Keeps the Record of Patients
2. Faster Bills Generation
3. Accurate Calculations by Computer Softwares
4. Helps in transfer of Patients Data Securely to the Service providers
5. Helps in transmission of request for Claims
6. Making it Error Free
7. Helps in Finding Codes Easily .
8. Plays Important role in Bringing Down the Cost Of HealthCare

The Evolution in the technology has Totally changes the approach of treatment towards the Patient and has reduced the workload of various Healthcare Staff members for Effective functioning also Technology plays an Important role in the upliftment of Various Surgical and Non-surgical Procedure for betterment of Patient and Helps the Physician to make Better diagnosis then Before it has Totally met the Expectations in Its Performance and hope it grows further for the betterment to Mankind.