Patient Accounting And Practice Management Systems Analysis

The customers of Duke Children’s hospital saw a major change in efficiency within the organization. Without cutting staff, the hospital was able to “improve their performance while enhancing quality” (Meliones, 2001). By implementing a new system of records, patients were able to pay bills on time without suffering through denial claims. Automatic reports gave patients the qualitative data they needed to for physicians and nurses to evaluate. The hospital was able to work in sync to provide excellent care for new patients.

In order to insure each staff member was obtaining their individual and team goals, each member was given their own business (Souza). The tools in which the PFS were given provided them with the tools to prioritize and automate account work lists, sort accounts in various ways and see at a glance their ranking with their work group and office-wide. Managers were given their own dashboard and tools which able them to use query all aspects of receivables for trending purposes and identify problem areas, drill down to the patient account level, monitor revenue, payments, adjustments, receivables, and days for periods from the previous day and week to the previous 18 months, calculate average daily revenue by day and 30-day period, assess their performance for the month to date, and estimate likely results at the month end, view all receivables or select any segment for quick analysis, and generate timely reports on demand, including aging analysis, A/R stratification, discharged not final billed (DNFB) analysis, credit balance analysis, and analysis of problem payers. Finally, a denials management component was implemented in late summer, which will allow registration staff to go online at the end of the year (Souza).

An increase in the number of closed networks, reimbursement changes, and risk-based contracts are just a few of the factors making the credentialing and payor enrollment processes more complex and more time consuming. Small healthcare organizations could certainly manage this process in-house if they have the money, expertise and staff. However, larger healthcare organizations, especially those that are growing, expanding or experiencing turnover, will find credentialing and payor enrollment to be a time-consuming and costly endeavor. This is especially true if these organizations rely on manual methods like paper documentation and spreadsheets to keep track of all their applications, contracts and renewal dates.

Thanks to technology, the human service field could become more efficient. Electronic filing of client or patient information puts the information at the fingertips of all involved in the care of each individual. Before computers, client or patient files were hard paper copies that only one person could have access to at a time within one office unless a copy of this file was made for each professional involved in his or her case. Technology changed this by someone creating software, which stores all information on the client or patient. The case manager can have access to

The practice management software allows activities such as patient care, scheduling, billing, claim processing, and other related operations. With this program doctors and staff can spend more time with patients and less time on administrative tasks. This program can be utilized by private practices, health centers, long

team due to its impact on both patient quality and employee productivity. Another plan developed by the QI team that required an immense analysis of it’s cost-benefit-quality balance is the implementation of the Electronic Health Records across all facilities and departments of the hospital. The cost to implement such a powerful system that can improve the productivity of the entire hospital is enormous. However, it’s ability to streamline information across all departments and facilities within the hospital provides a lot of benefits that will eventually increase the quality of care delivered to patients and the productivity of employees. A reduction in silos among

After examining the information obtained from the analysis and realizing the importance of standardization throughout the organization, Sutter developed a solution that best fit their current situation. First on the agenda was to develop a standardized system within the entire Sutter Health organization. The organization chose a program based on the criteria that the program met or exceeded existing functionality, be easy to use, be cost effective and represent advanced and/or adaptive technology. (Anonymous, 2005) Sutter Health chose to use the MedSeries4 (MS4) throughout all of their facilities. This program has helped to standardize the organization’s patient accounting processes. The staff of Sutter Health is now able to prioritize and follow up on financial counseling, third-party payer billing and collection activities through an automated collection system. This system also has the capability of producing daily work list based on manager-defined account receivable criteria. Each facility is able to track accounts from the moment of

I review the patient account#12948701 and the account doesn't have any pending balance. I contact the patient and she only needs to know what is the process to get her BTL done.I advise the patient that she will need to contact the scheduling department and schedule appointment with the provider.Also I advise the patient that she need to come to see F.A department b/c her scale expired. The patient understood everything and she was agree to come to see the provider.

After reviewing Figure 1 & 2, I recommend the practice purchase System B. Both System A & B offer many of the same key attributes needed of a computer-based patient record system identified by the Institute of Medicine in 1991. However, one main reasoning for choosing System B over A is that System A does not have the capacity to offer tailored views. The benefit of an EMR/EHR system that can offer tailored views, goes beyond meeting functionality needs and is a benefit that can greatly aid in the successful user integration of the computerized order entry function (CPOE) of the system. Recent studies show there is great value in having an EMR/EHR system that is specifically designed to meet the practice’s needs or offers tailored views to reduce user fatigue and support the proper use of the system (Russ, Zillich, McManus, Doebbelingb & Saleem, 2012). Tailored views improve the user’s experience with the technology, make it easier

Practice management system (PMS) assist healthcare professionals in manage their daily workflow in out-patient setting by allowing the professionals to record patients’ identifications and registrations, arrange appointment schedules, capture insurance information as well as create reports and submit claims and billing. PMS assures all administrative and financial tasks are properly recorded and processed while allowing healthcare professionals to spend more time with patients and ensure they receive the high quality of cares (Wikipedia, 2017).

Sophisticated electronic records and computer systems for tracking patient care is another important attribute of Kaiser. Since five years, Kaiser is using the electronic information to identify and evaluate providers’ strengths and weaknesses in order to improve the quality of care (Abelson, 2013). The organization also uses the electronic records to improve its care delivery, e.g. by identifying at-risk patients and establishing alert and reminder systems for quick and timely care

The implementation of new technology, such as electronic charting can without doubt benefit the patient as this can lead to a higher quality of care for the patient (Menachemi & Collum, 2011) signifying its importance . Although this comes with benefits to the patient providers are resistant to the idea of integrating these technological advances into their practice. They are resistant to this idea as it does not come without a price, the cost to initiate these systems ranges from $14,000-$19,000 depending on the number of physicians that are in the office. Not only do they have the initial cost, but they also accrue loses as they are implementing and adapting to the new system. The system also requires maintenance such as software upgrades

Over the years technology has become more involved in our everyday living and to the human service field is more efficient. From electronic filing of a client or patient information puts the information at the fingertips of all involved in the care of each. Before computers, clients or patients files were hard copies that only a few people within that organization had access. Technology changed this by creating software, which stores all information on the client or patient. Everyone within the organization can have access to these files. The software is used to track client or patient services. With all things, there are pros and cons. Depending on the size of the organization, can have a deciding factor on which software the organization will use for the filing of a client or patient information. The following will discuss two types of software created for this purpose and explain how it is used, the pros to centralize electronic clients records and human services resources and the cons of each software and how the size of the organization determines which software it will use. These two software names are Client Track and Apricot.

It is important for billers and coders to be familiar with software programs because the healthcare industry is switching over to computerized patient documentation (EHR and EMR) and computerized insurance carrier billing for services and equipment, as well as computerized benefit and coverage verification. These types of healthcare facility specific software programs fall under the generic heading Medical Practice Management Software. Obviously some medical facilities are further along in the actual use of all the medical practice management software that is available, the financial incentives from Medicare and other insurance carriers for implementing such software and the long-term advantages that come with its use pretty well

The first information system is Electronic Medical Record (EMR). EMR used in a consistent and meaningful way across the accountable care enterprise to document patients’ healthcare status and treatment and support safe, evidence based care. Health Information Exchange (HIE) is used to enable the sharing of patients’ clinical data across disparate EMRs in the accountable care enterprise. An Activity Based Costing (ABC) system is used to precisely understand cost of production and revenue margins in