The Federal government announced in 2014 an initiative to create a seamless national health information system - Electronic Health Record (EHR) for virtually every American. HIPAA requirements, require the majority of the hospital claims to be transmitted electronically, hospitals are already using patient accounting software to automate the claim preapation process for managing patient accounts, for creating claims and transmitting them to payers, and for electronic reimbursement. The Information Technology movement in health care management is to implement EHR system in replacing paper files and interface these systems with new accounting systems. EHR systems capture and store each patient's clinical data electronically, from lab test to digital images records. EHR system has many advantages:
1. Quick access to health information: EHR is accessible from workstations in all departments of the hospital to remote sites like physician's office. Information retrieval from EHR is quick and critical in emergency situations.
2. Computerized Physician's Management of Orders: Physician orders medications, tests, and other s services at anytime. The information is available throughout the patient's hospital visit.
3. Clinical Decision Support: EHR immediately can access medical research to facilitate Medical Decision Making (MDM).
4. Automated Alerts and Reminders: The system can give alert and remind staff workers to ensure patient are scheduled for required tests or preventive services. It can also alert the practice identifying patient's safety such as allergic reaction to, food, drugs and drug interactions as well.
5. Electronic Communication and Connectivity: Access communication between physician, staff members and even patient portal access.
6. Patient Support tools: EHR can also provide access to their health records and to request appointment electronically. EHR offer patient education on health topics and instructions on preparing for common medical laboratory tests.
7. Administrative reporting tools: Tools that includes reporting systems that enable hospitals to comply with federal and state reporting requirements for clinical data.
8. Reduce Error: EHR can decreased medical errors that a result of illegal chart notes, as notes are no longer entered manually. The notes are entered electronically using a computer or handheld device.
Additionally, an electronic encounter form contained in the handheld device or computer used by a physician to enter the services rendered during patient encounters, allowing for greater accuracy and consistency in reporting services rendered.
Many electronic devices and software programs for capturing patient information during admission process can be used in EHR system, such as:
Scanners: Used to create digital images of patient's cards or other forms of identification, such as driver's licenses, as well as physician's orders during the admission process.
Electronic Signature Pads: Electronic clip board devices that capture legally binding signatures from patients, or electronic forms that incorporate electronic signatures, for use with consent and disclosure forms during check in.
Patient Verification Software: Used to determine a patient's ability to pay and to verify a patient's billing address before services are received and to screen self-pay patients to determine whether they qualify to alternative funding sources such as Medicaid.
Medical Kiosks: Self-serve preregistration kiosks wherein patients enters there demographic information themselves and also possible check in, make payments, update information, and obtain patient education.
Electronic Insurance Verification: Web-based products that query the patient's insurance and demographic information for insursance verification before services are rendered.
Admission "scrubber" programs: Used with electronic admission forms to screen each admission for errors that could cause denials or delays later in the billing process.
EHR system raise confidentiality and security concerns. The storage of patient information on a computer and its transmission from one computer to another significant risks. However, it is widely accepted that the increase use of information technology in healthcare management greatly improves the productivity and efficiency of data that are collected and processed in billing process.
Type of
Bill5. Electronic Communication and Connectivity: Access communication between physician, staff members and even patient portal access.
6. Patient Support tools: EHR can also provide access to their health records and to request appointment electronically. EHR offer patient education on health topics and instructions on preparing for common medical laboratory tests.
7. Administrative reporting tools: Tools that includes reporting systems that enable hospitals to comply with federal and state reporting requirements for clinical data.
8. Reduce Error: EHR can decreased medical errors that a result of illegal chart notes, as notes are no longer entered manually. The notes are entered electronically using a computer or handheld device.
Additionally, an electronic encounter form contained in the handheld device or computer used by a physician to enter the services rendered during patient encounters, allowing for greater accuracy and consistency in reporting services rendered.
Many electronic devices and software programs for capturing patient information during admission process can be used in EHR system, such as:
Scanners: Used to create digital images of patient's cards or other forms of identification, such as driver's licenses, as well as physician's orders during the admission process.
Electronic Signature Pads: Electronic clip board devices that capture legally binding signatures from patients, or electronic forms that incorporate electronic signatures, for use with consent and disclosure forms during check in.
Patient Verification Software: Used to determine a patient's ability to pay and to verify a patient's billing address before services are received and to screen self-pay patients to determine whether they qualify to alternative funding sources such as Medicaid.
Medical Kiosks: Self-serve preregistration kiosks wherein patients enters there demographic information themselves and also possible check in, make payments, update information, and obtain patient education.
Electronic Insurance Verification: Web-based products that query the patient's insurance and demographic information for insursance verification before services are rendered.
Admission "scrubber" programs: Used with electronic admission forms to screen each admission for errors that could cause denials or delays later in the billing process.
EHR system raise confidentiality and security concerns. The storage of patient information on a computer and its transmission from one computer to another significant risks. However, it is widely accepted that the increase use of information technology in healthcare management greatly improves the productivity and efficiency of data that are collected and processed in billing process.
For Your Information:
In Paper claim or UB-04/CMS-1450
leading zero in TOB (FL 4) is reported.
In electronic claim 837I the
leading zero in TOB (FL4) is NOT reported.
Coding
Structure
Click the image below to make it more larger.
Coding Structure Third Digit - Type of Services Received
There are three groups of services in third digits of the TOB if you look closely the picture above:
1. Bill Classification - except clinics and special facilities
2. Classification for clinics only
3. Classification of special facilities only
The first group contains the major bill classifications based o n the type of care received, such as inpatient care, outpatient care, or clinic care. If the second digit of TOB is 7 or 8, however, the other two types of classification are used. Each contains a special set of codes - one for the clinic and the other for special facilities - to further clarify the type of care received.
Samples - Click the image below to make it more larger.
Internet Useful Resources:
