EDI In The Health Care Industry

This paper will illustrate how Hennepin County (HC) utilize monitor and maintain EHR records for the following business lines hospital, outpatient clinics, health, social and human service. Data sharing of EHR has allowed the organization to successfully provide care coordination for the population we serve. As healthcare evolves and service delivery continues to influence healthcare, it is essential that each business lines work together and collaborate to effectively access EHR within the Epic system. EHR systems, data bases, web portals are critical for a healthcare provider remain compliant with federal regulations. I am an HC employee, and my organization is unique, because we own and operate Hennepin County Medical Center (HCMC) and

The purpose of the HIPAA transactions and code set standards is to simplify the processes and decrease the costs associated with payment for health care services. The transactions and code set standards apply to patient-identifiable health information transmitted electronically. Physician practices will continue to be able to submit paper claims. When the regulations take effect in October 2002, standard formats and code sets will take the place of any payer-specific or location-specific formats or requirements. ICD-9-CM Volume 1 and 2: Diagnosis Coding - ICD-9-CM is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.

Healthcare Reimbursement Healthcare is made up of many factors. Among those factors are provider reimbursement and the different types of financial methods used by the patients to acquire healthcare services. Provider reimbursement is important and necessary in order to maintain the continuation of healthcare. Like every organization, including non-profit organizations, require revenue in order to pay their healthcare providers, expenses accrued, and to obtain the supplies needed to aid in rendering services. With that said, this is why there are many financial methods such as third-party payers, government agencies, private health insurance, and patient payments.

This rule adopts standards for eight electronic transactions and for code sets to be used in those transactions. It also contains requirements concerning the use of these standards by health plans, health care clearinghouses, and certain health care providers. The use of these standard transactions and code sets will improve the Medicare and Medicaid programs and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It implements some of the requirements of the Administrative Simplification subtitle of the Health Insurance.

Electronic Medical Records has several positive effects on the billing and coding process. For example, Electronic Medical Records helps to reduce cost for physicians and improve care for patients. Electronic Medical Records helps reduce medical errors for the physicians and unneeded diagnostic tests. The EMR can also help coordinate patient's information better such as diagnosis, medications, family history, and the test results of each patient on file. Electronic Medical Records helps to improve storing health information and EMR makes it easier to track results of each patient.

The focus of this paper will be geared toward the impact that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Health Information Technology have on the cost of health care. The regulations connected to HIPAA have an impact on cost through enforcement, noncompliance, and implementation. HIPAA is a vital tool in the protection of PHI of patients and the improvement of the Medicare and Medicaid programs (Cleverly). Trying to contribute to the improvement of Medicare alone can be a daunting and expensive task alone, but to add the addition of protecting the health records of millions of patients adds to the rising cost. Health Information Technology (HIT), aids in the enforcement of HIPAA and helps with billing patients accurately for services that they have received (Wizemann).

Career Current Issue Current Issue Background HIPAA (Health Insurance Portability and Accountability Act), was put in place in 1996. It’s main objective, stated by McGowan (2012), is to “...improve continuity of health insurance coverage, combat health care waste and fraud, and simplify the administration of health insurance” (p. 61). The Privacy Rule was added in 2003; it protects demographic information, including individuals past/present/future condition, care given, payment information, their address, date of birth, etc. Therefore, nurses, doctors, and other health care providers must pay special attention to what they are sharing.

(September 30, 2013) - The Department of Health and Human Services (HHS) published amended rules applicable to the Health Insurance Portability and Accountability Act (HIPAA) of 1996 in January 2013. As explained by the Secretary of HHS, healthcare has experienced significant changes since HIPAA was enacted in 1996. The implementation of electronic medical records is just one of those changes. The new HIPAA regulations are designed to provide patients with better privacy protection, and additional rights not included in the original HIPAA rules.

In her assessment of the American Reinvestment & Recovery Act (ARRA), Murphy (2009) discusses how its enactment provided unprecedented funding for the advancement of health information technology (HIT) which served to promote health care reform. Electronic health records (EHRs) by extension received a boost via incentivization for appropriate use in hospitals and ambulatory settings (Murphy, 2009). The benefits of EHRs include the ability to improve the delivery and quality of nursing care, the ability to make more timely and efficient nursing care decisions for nursing, the ability to avoid errors that might harm patients and the ability to promote health and wellness for the patients (McGonigle & Mastrian, 2015). An appropriate use of EHR

The ROI of EHRs article breaks down the importance of Electronic health records. Healthcare leaders need to have an open-mind about electronic health records to gain a better organized system. Health organizations spend billions trying to find a working system instead of changing to the electronic health records system. Most organizations are making their IT department play bigger role working along with physicians to make electronic health records a key component of healthcare facilities making EHRs an effective program. Electronic Health Records are important to improving the quality of care provided, being able to find a patients history of care at a click of a button.

“Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care” (HealthIT, 2014). Health Information exchange is becoming important in the communication between providers to provide the best care possible to patients. Every state along with their hospitals has their own way of exchanging information between each other. South Carolina’s health information exchange is called “SCHIEx” (AHIMA, 2010). “SCHIEx provides a state-level information infrastructure for connecting local healthcare providers and other stakeholders” (AHIMA,

It is important to enter all pertinent patient’s information into the Electronic Health Record as soon as possible to allow for the smooth provision of medical services. The information must be current and it must be accurate. There can be no errors on your part. Errors or mistakes can lead to wrong diagnosis and wrong treatment that could cost valuable time and money. It could even cost a patient their life.

You need a system that can keep up with this ever changing world to give the patients the best care possible. There is new procedures, information, diseases, and advances in science on a daily basis and if you don 't have a system that can keep up with all of the changes, you can waste time and money along with the loss of patients. Patients need and deserve the best care possible and it 's up to the doctors to make that happen. Organization is going to be a key component in an EHR system as you need important information and fast in some instances and if you don 't have a well-organized system, it could mean life or death, in some situations.

Adding more parties to sharing data along with the time it takes to complete a cohesive DURSA agreement can be lengthy and costly. Another challenge of HIE is that HIEs can sometimes be viewed as providing duplicative information or solutions offering patient portals or patient related information directly to the consumer. Health information exchange has three key forms: directed exchange, query-based exchange, and consumer mediated exchange. Directed exchange is the “ability to send and receive secure information electronically between care providers to support coordinated care” Examples of patient information include ancillary test orders and results, patient care summaries, or consultation reports. The encrypted patient information is electronically sent securely between parties with an established relationship.

You will be amazed how technology has made it easier for patients to maintain their own health record so they can recieve better quality healthcare services. What is personal health record? A personal health record (PHR) allows you to securely collect store, manage and share your own and your family's health records - whenever you want, where you want, and with whom you prefer.