Part A
1. What are the key data elements included in the CDM?
Below are the key data elements included in the CDM:
• Department number – This serves as a unique identifier that identifies the location of the services provided (i.e. department of hospital/health care facility)
• Service item number – This is the number assigned to each service/supply/procedure provided to the patient. It is an internal number that will trigger a charge to the patient’s account.
• Service item description – Brief description of service/supply/procedure (i.e. chest x-ray, single view).
• General ledger number – This number connects the CDM to the hospital’s internal record system.
• UB92 revenue code – This is a 3 digit number that corresponds to a specific …show more content…
Review the RCM case study in Chapter 9 of Castro and Forrestal (pages 268-270 of Chapter 9; included in the readings section). Specifically, refer to the problems with OCE edits 41, 48, and 38. Assuming Anywhere Hospital has the same issues as the case study pointed out, does Todd White's integrated RCM and team approach help solve the problems outlined in this case study? Why or why not?
I believe that the integrated RCM approach would help solve the problems outlined in the case study. For OCE edit 41, if there were members from several departments involved in the CDM review, perhaps the manager of therapy services would have noticed the entry error for the physical therapy services. Likewise, perhaps a member from another department would notice the error as they are an outsider looking in and may have a more analytical view of the codes entered as they are not as familiar with them. Likewise, OCE edit 38 may have been prevented if members of the cardiac services department were involved with the CDM reviews. Many of the corrective actions taken in the case study are reactionary rather than being proactive. The team approach that Todd want’s to implement could potentially prevent many of these issues. There will always be some data entry errors that slip through the cracks, but limiting the errors through the team approach would have an overall …show more content…
What are benefits and risks of PHRs?
There are many benefits that a PHR can provide not only to patients, but to their physicians. By using a PHR, patients would be able to have more channels to communicate with their providers and allow providers to give patients feedback and information without needing the patient to come into the office. Patients will also have access to their health information when they are traveling as well as have easy access to physician instructions, medication lists, billing information, etc. Providers will also be able to provide more information to their patients in a format that is easily accessible and retrievable.
Potential risks could depend on the medium used for storing the PHR. The largest concern would be the privacy of the health information stored in the PHR. The PHR vendor needs to ensure that patients agree to terms of service as well as provide strict login requirements to protect the information of patients. CMS also should set high standards and best practices for PHR vendors to ensure that they meet HIPAA
1. What are the key data elements included in the CDM?
Below are the key data elements included in the CDM:
• Department number – This serves as a unique identifier that identifies the location of the services provided (i.e. department of hospital/health care facility)
• Service item number – This is the number assigned to each service/supply/procedure provided to the patient. It is an internal number that will trigger a charge to the patient’s account.
• Service item description – Brief description of service/supply/procedure (i.e. chest x-ray, single view).
• General ledger number – This number connects the CDM to the hospital’s internal record system.
• UB92 revenue code – This is a 3 digit number that corresponds to a specific …show more content…
Review the RCM case study in Chapter 9 of Castro and Forrestal (pages 268-270 of Chapter 9; included in the readings section). Specifically, refer to the problems with OCE edits 41, 48, and 38. Assuming Anywhere Hospital has the same issues as the case study pointed out, does Todd White's integrated RCM and team approach help solve the problems outlined in this case study? Why or why not?
I believe that the integrated RCM approach would help solve the problems outlined in the case study. For OCE edit 41, if there were members from several departments involved in the CDM review, perhaps the manager of therapy services would have noticed the entry error for the physical therapy services. Likewise, perhaps a member from another department would notice the error as they are an outsider looking in and may have a more analytical view of the codes entered as they are not as familiar with them. Likewise, OCE edit 38 may have been prevented if members of the cardiac services department were involved with the CDM reviews. Many of the corrective actions taken in the case study are reactionary rather than being proactive. The team approach that Todd want’s to implement could potentially prevent many of these issues. There will always be some data entry errors that slip through the cracks, but limiting the errors through the team approach would have an overall …show more content…
What are benefits and risks of PHRs?
There are many benefits that a PHR can provide not only to patients, but to their physicians. By using a PHR, patients would be able to have more channels to communicate with their providers and allow providers to give patients feedback and information without needing the patient to come into the office. Patients will also have access to their health information when they are traveling as well as have easy access to physician instructions, medication lists, billing information, etc. Providers will also be able to provide more information to their patients in a format that is easily accessible and retrievable.
Potential risks could depend on the medium used for storing the PHR. The largest concern would be the privacy of the health information stored in the PHR. The PHR vendor needs to ensure that patients agree to terms of service as well as provide strict login requirements to protect the information of patients. CMS also should set high standards and best practices for PHR vendors to ensure that they meet HIPAA