HIM 445 Journal Internship Midpoint

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School

Southern New Hampshire University *

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Course

445

Subject

Information Systems

Date

Feb 20, 2024

Type

docx

Pages

3

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Journal: Internship Midpoint Alexis Sanchez Southern New Hampshire University HIM 445: Professional Practical Experience Sandra Masten February 4, 2024
The most significant event I encountered with the EHR was inconsistencies with data entry concerning patient insurance information. It appears the demographic template has certain fields, like the insurance member ID, which do not require data entry, indicating the user can overlook this information, save, and move forward without an alert for incompleteness. Another instance is uploading insurance card copies. The template allows a user to scan copies of a patient's insurance card, but the common occurrence is finding this space empty, so there is no way to validate primary or secondary insurance unless running the patient through an eligibility check. When undergoing this process, there are instances where I received a rejection message stating the member ID is incorrect, the date of birth, or the spelling of the name. Without a copy of the insurance card, I cannot validate insurance or move forward with claim billing, impeding the work process. From my experience with this EHR so far, I am learning the importance of properly setting up data entry templates. Another learned lesson was understanding the EHR does not always contain updated or correct insurance information, as seen when reviewing claim rejections in the clearinghouse. Some rejections note inactive member IDs or describe billing incorrect insurance altogether. This issue circles back to running eligibility checks on patient information, however, if the demographic template does not require the user to enter in member IDs or upload copies of insurance cards, I cannot file or correct existing rejected claims. The only option to resolve the situation is to call the insurance company. There are other issues with the EHR, but I believe those stems from me still learning the nuances or how to properly use it. Apart from this, the best quality of the EHR is the information display setup. When querying signed patient encounters, I can easily locate the patient's name, date of birth, provider,
date of service, procedure code, diagnosis codes, and insurance details. Another feature is the ability to group patients by name, so when performing billing, I can enter multiple claims for the month or week at one time for a single patient versus entering single claims, which seems more productive and efficient. I also enjoy using the date range selection, where I can see how many and which patients a provider saw in the last 7 days, 30 days, 90 days, 6 months, or 12 months. I find these menu options useful when tracing claims and narrowing a billing period.
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