Chapter 4, Problem 11R

The History of Electronic Health Records (EHR). a. Describe how they have changed the healthcare industry.    b. What are the advantages and disadvantages of their use?    c. Please compare the use of paper-based records to EHR in the following categories:   Appointment scheduling Verification of insurance benefits Appointment reminders Storage and maintenance of patient records

A health line for private physicians and Veterans to consult with a health administrator who has access to a team of medical staff and accounting/billing/insurance staff. the short-term, long-term, immediate implementation

With the use of Electronic Health Records most healthcare facilities and offices no longer submit a paper claim form instead of the fields in the EHR translate in the background to an electronic format of the CMS 1500 (physician claim) or a UB04 (hospital claim) form. However, it is still essential that you understand how to complete a claim form properly. In reviewing the different Blocks on the CMS 1500 form, choose a section of Blocks (as discussed in the unit) and in your own words: List the Block Numbers (i.e., Blocks 1-8), Describe what information goes into the Blocks Discuss any formatting requirements for the Blocks and what happens to a claim if the formatting is incorrect. In the second document above, CMS discusses Incomplete or Invalid Submissions. Explain how the Part A/Part B Medicare Administrative Contractors (MAC) handles these types of claims. CMS also discusses the difference between a “clean claim” and “other-than-clean claims.” Explain in your own words the…

Effective healthcare organizations must consist of talented, skilled, and experienced IT individuals in leadership positions. Discuss some of the attributes required of a leader on a HIT staff.

The Centers for Medicare & Medicaid Services (CMS) is responsible for Accountable Care Organizations (ACOs). Describe one of the types of ACOs available to providers. Reply to at least two (2) classmates, with a minimum of 75 words each post.   Why is it so important to accurately code diagnoses and procedures as this relates to the ACOs?

The LPN/LVN is preparing to take a verbal medication order over the telephone from a health-care provider. For which reason would this action be permitted by the LPN/LVN? The RN is going home with a sudden fever and vomiting. The order is in response to the emergency need for a patient. The LPN/LVN is the only person at the nursing station. The action is supported by both state board and facility policy.

To process claims accurately and effectively, billing professionals must understand how a clean claim is prepared and what issues can contribute to a dirty claim. When managing a team of billing professionals, it is important to understand how internal and external factors contribute to a smooth process vs. a rejection or denial. Summarize internal factors (within your organization/facility) that can positively or negatively influence the life cycle of a claim. Summarize external factors (outside of your organization/facility) that can positively or negatively influence the life cycle of a claim. From a leadership perspective, how can you ensure your team is effectively trained and confident in navigating internal and external challenges with claim processing? Please be sure to validate your opinions and ideas with citations and references in APA format.

Discuss the importance of advocacy as it pertains to patient care. What is the nurse's role in patient advocacy? Describe a situation in which you were involved with patient advocacy. Explain what the advocacy accomplished for the patient, and what the repercussions would have been if the patient would not have had an advocate.

The difference between a remittance advice (RA) and an explanation of benefits (EOB) is:   The RA goes to the provider only and includes payment information.    The EOB goes to the provider.   The RA is sent to the patient and includes payment information.   The EOB contains payment information.