Preview

Hospital and Appointment Management Purposes

Satisfactory Essays
Open Document
Open Document
472 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Hospital and Appointment Management Purposes
Homework Assignment #2

03/04/13
Please provide your answer after each problem and submit the file with your answers through Angel.

Problem #8 from page 145
Using the Crow’s Foot methodology, create an ERD that can be implemented for a medical clinic, using at least the following business rules: a. A patient can make many appointments with one or more doctors in the clinic, and a doctor can accept appointments with many patients. However, each appointment is made with only one doctor and one patient. b. Emergency cases do not require an appointment. However, for appointment management purposes, an emergency is entered in the appointment book as “unscheduled.” c. If kept, an appointment yields a visit with the doctor specified in the appointment. The visit yields a diagnosis and, when appropriate, treatment. d. With each visit, the patient’s records are updated to provide a medical history e. Each patient visit creates a bill. Each patient visit is billed by one doctor, and each doctor can bill many patients. f. Each bill must be paid. However, a bill may be paid in many installments, and a payment may cover more than one bill. g. A patient may pay the bill directly, or the bill may be the basis for a claim submitted to an insurance company. h. If the bill is paid by an insurance company, the deductible is submitted to the patient for payment.

[pic]

Problem #2 from page 173
Given the following business scenario, create a Crow’s Foot ERD using a specialization hierarchy if appropriate. Tiny Hospital keeps information on patients and hospital rooms. The system assigns each patient a patient ID number. In addition, the patient’s name and date of birth are recorded. Some patients are resident patients (they spend at least one night in the hospital) and others are outpatients (they are treated and released). Resident patients are assigned to a room. Each room is identified by a room number. The system also

You May Also Find These Documents Helpful

  • Good Essays

    A: Some patients may be experiencing a financial difficulty and cannot pay a balance in its entirety. By offering other payment options like setting up a payment plan where the patient agrees to pay a portion of their balance by a certain date each month or week, allows them to pay their bill but not add further financial strain or stress on the patient. The patient is still meeting their obligation, the office still gets paid and it allows for a good relationship to continue between the patient and…

    • 602 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Assignment CaseProblems

    • 819 Words
    • 4 Pages

    with the hospital the payment for services to be rendered by the hospital. The first of these four…

    • 819 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Bsbwor504 Final Project

    • 887 Words
    • 4 Pages

    | | |Admitting Clerk will assign the In-coming Patient Record to the Department Admin and direct the Patient to meet |…

    • 887 Words
    • 4 Pages
    Good Essays
  • Good Essays

    There are ten steps included in the billing process and are used to help process the patient’s information from preregistration to the follow up payments. Each patient has the responsibility to pay for their services once they have received care from a facility by themselves or an insurance company. Many different health insurance companies that may help an individual cover their medical expenses or even pay the entire bill. This billing process is usually done in the back office whereas the registration and collection of information is done in the front office.…

    • 749 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Hcr220 Week 7 Checkpoint

    • 314 Words
    • 2 Pages

    Billing non-covered services is an issue for not only the insurance company but as well as the patient and yourself. It wastes your time as well as the insurance company’s time. It causes a hassle for the patient as well. A simple solution to correct this billing issue is to make sure a service is covered and is able to be billed before performing the service or contacting the insurance company. This will allow the patient to prepare for anything not covered by their provider.…

    • 314 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    Many of our patients have been in car accidents or slip and falls, they are being referred to our surgeons, neurologists, primary physicians, and orthopedists from attorneys. If the pain is tolerable we do not recommend surgery, however when patients are in excruciating pain we have them see our neurologist to have various neurological tests performed. When we have a new patient referred to our office, we gather all of their demographics and insurance information, if they do not have insurance many times there is a liable party information involved.. First we call the attorney to get more information on the case, next we fax the attorney letters of protection. Some of our cases are funded so we fax the funding company the information…

    • 542 Words
    • 3 Pages
    Satisfactory Essays
  • Better Essays

    2. Establish Financial Responsibility – When a patient has insurance; the health plan coverage should be reviewed and eligibility needs to be verified (Valerius, Bayes, Newby, & Seggern, 2008). It should also be determined whether or not there is more than one insurance company. If that is the case, the first payer should be determined. Check to verify that all conditions for payment have been met and the correct steps followed to assure payment for service (Valerius et al.).…

    • 958 Words
    • 4 Pages
    Better Essays
  • Good Essays

    Mism Phs Case Study

    • 610 Words
    • 3 Pages

    1. Create a table that lists the benefits to the patient and to the hospital of an enterprise system for patient medical information and for patient prescriptions and related medical therapies.…

    • 610 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    There are ten basic steps in the medical billing process. Each step has certain things which must be done to correctly complete the entire process. In order to complete your duties as a medical biller efficiently, you must follow the medical billing process. Following this process leads to maximum and appropriate payments in a timely fashion. These steps range from the pre registration of the patient to the collection of the payment. In this paper each step will be describe with a brief outline of what each step entails.…

    • 748 Words
    • 3 Pages
    Satisfactory Essays
  • Better Essays

    The receptionist or other clerical worker will either call, or receive a call from a “patient” or other authorized individual. During this communication, the associate must be careful to observe HIPAA rules related to “protected health information.” when “schedule, canceling, or rescheduling” encounters. When gathering benefit “information,” the representative must be diligent to accurately enter data into the “patient’s” file. Discerning insurance cards, policies, and all applicable guidelines of each plan are applicable to the “front and back” office. Abiding by the payer’s regulations, and the coordination of benefits,” associates will input this data into the patient management program (PMP). During these procedures, insurance specialists will be cautious to correlate the correct information with the correct patient. The “front or back office” will then confirm coverage with designated plans, along with all essentials, such as if a “referral or preauthorization” is a requisite. Prior to consulting with the physician, patients will need to be alerted about their rights, in coordination with HIPAA privacy standards, as well as those of the provider. During that time, if the patient owes any monies for coinsurance, or copayments, this will be submitted to the “front office.” While checking out patients, insurance specialists will transfer the descriptions of “diagnoses and procedures” from the “physician’s report” into appropriate “codes” for ‘claim” generation. This facet is most crucial, because of the HIPAA specifications regarding the transfer of PHI “by covered entities” (Valerius et al., p.…

    • 1235 Words
    • 5 Pages
    Better Essays
  • Good Essays

    Payment Entry Process

    • 1356 Words
    • 6 Pages

    Depending on the type of coverage, the patient will have to pay $500 or $1000 for his medical treatment before his insurance company starts paying on his behalf. Some insurance companies have a yearly deductible, which means that every calendar year the patient would be responsible for a certain amount of money before their insurance starts paying their medical bills for that year. Other insurances have a lifetime deductible, which means that the patient will have to pay for his treatment until a certain limit (like $5000) and then the insurance would start paying till his coverage is valid.Co-insurance/co-payment: A primary insurance company makes a payment on a claim to a participating physician. They instruct the physician’s office to collect a specified amount from the secondary insurance or the patient. This specified amount is called a co-insurance or co-payment.Balance bill: When a non-participating primary insurance co. pays a part of a claim, the balance on the claim can be billed to the patient or secondary ins. Regardless of the non-participating ins. Allowed amount.Out of pocket Expenses: A medical bill or part of medical bill paid by patient out of his pocket because of non payment of his insurance company is called Out of pocket expenses. Deductible, co-pay, co-insurance and balance bills are “Out of pocket…

    • 1356 Words
    • 6 Pages
    Good Essays
  • Satisfactory Essays

    * This is a very important step because it involves the determining of who is financially responsible for the visit. It also is used to establish what services may be covered under the type of insurance they have, along with payment options plan options if any, and what types may be available to the patient.…

    • 672 Words
    • 3 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Step2. Establish financial responsibility for visits; this step is very important to determine financial responsibility for the visit. Insured patients will be asked questions about what services are covered under their plan, medical conditions that establish medical necessity for the services, what services are not covered, and how much of the bill is the patient responsible for. You must verify patients’ eligibility for their health plan in case it has expired or there has been changes made.…

    • 613 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    1. When the patient is contacted, you must identify yourself, the practice, and the purpose of the call. When you are speaking to the patient, you must verify that the patient has received a copy of the bill. You must also inform the patient of the status of their account and what needs to be accomplished.…

    • 390 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Fundamentals Review

    • 360 Words
    • 2 Pages

    C) “I always try to keep an open mind about what interventions my client will require.”…

    • 360 Words
    • 2 Pages
    Good Essays