PHS -Chapter 3 (Slides 15-25) Information Tech & Medical Math

Ch. 3: Fundamental Skills in Health Informatics

(Slides 15-25)

1. Information Technology

-EHR's
-Applications

2. Medical Math

-Numerical Data / Charts & Graphs

-Reimbursement

Information Technology 🖥️

Information technology (IT) plays a key role in modern healthcare by improving the quality, efficiency, and safety of patient care. Here are some ways IT is used in HI:

• Electronic Health Record (EHR):

  A complete digital record of a patient’s care from all providers🩺

• Continuity of Care Records (CCR):

  A (CCR) is a standardized electronic summary of a patient’s key medical information for quick, accurate sharing when care is transferred to another provider. 🔄

• Personal Health Records (PHR):
  A personal health record (PHR) is a patient-managed record of their medical information to track health and share with providers. 📅📊💬

• Send documents using a phone line ☎️

• Cover sheet includes:

  • Sender’s contact info 📞

  • Recipient’s name 👤

  • Date 📅

  • Total number of pages #️⃣

  • Confidentiality statement 🔒

Fax Machines in Healthcare 📠

• Emails are secure and encrypted 🔒

• Use email only for business purposes 💼

• Write with formal language 📝

• Be concise; focus on one subject per message ✔️

Emails and Faxing in Healthcare 📧📠

​Email is now more common than paper mail ✉️➡️📧

Critical Thinking...

How can you protect patient privacy when using e-mail and fax machines? 🔒

• Get written permission before sharing patient info 📝

• Use BCC (Blind CC) to keep email addresses private 📧

• Always use a fax cover sheet and wait for it to send 📠

• Double-check email addresses and fax numbers before sending ✔️

Multiple Choice

• A complete computerized record for a patient containing information from all his/her care providers

• electronic health record (EHR)

• patient portfolio

• medical record

• files

Multiple Select

How can you protect patient privacy when using e-mail and fax? (select 2)

• use a cover sheet for faxes

• Double-check contacts before sending

• avoid getting a written release when sharing patient information

• leave pages with patient information in the fax machine

• Data: Facts about a topic used for reference or analysis 📊

• Statistics: Collecting, organizing, and interpreting numerical data 📈

• Mean, Median, Mode: Ways to describe and compare data 📐

​Understanding Numerical Data 🔢

​Charts and Graphs📊

Visual displays make data easier to understand, compare, and use 👀

• Five Basic Types:

  • Simple table: rows & columns 📋

  • Line graph: changes over time 📈

  • Bar graph: comparisons 📊

  • Circle graph / pie chart: parts of a whole 🥧

  • Pictograph: data shown with images 🖼️

Match

Match the types of graphs:

bar graph

circle graph/pie chart

line graph

simple table

pictograph

• bar graph

• circle graph/pie chart

• line graph

• simple table

• pictograph

• Health informatics workers’ role in collecting reimbursement:

  • Code diagnoses & procedures 🏷️

  • Complete insurance claim forms 📄

  • Receive & record office payments 💰

  • Make bank deposits 🏦

Reimbursement means Payment for healthcare services 🏥

Reimbursement Tasks 💵

Medical Coding

Purposes of Coding:

• Reimbursement 💵

• Research 🔬

• Public Health 🩺

• Patient Care ❤️

Two systems for coding:

• ICD: International Classification of Diseases 🌍

• CPT: Physician’s Current Procedural Terminology 🩺

Critical Thinking🧠

​What can happen if a patient’s medical chart is not coded properly?

• Provider may not be reimbursed correctly 💵

• Patient may be overcharged or undercharged 💰

• Errors can affect research, public health, and patient care 🩺📊

Multiple Choice

What term means payment for services.

• reimbursement

• coding

• claim

• billing

Claims Process 📄💵

Submitting costs for medical services:
Sending a claim to the insurance company so they can either pay the provider or explain why they won’t. 🏥

Assignment of Benefits:
When a patient signs a form giving the provider permission to send medical details to the insurer and have insurance payments sent directly to the provider. 🖊️

Explanation of Benefits (EOB):
A statement from the insurance company that shows what they paid, what charges remain the patient’s responsibility, and the reason for any unpaid amounts. 📋

Claims Process 📄💵

​​Claims Process Flowchart

• Patient receives medical services 🏥
  ⬇️

• Healthcare provider codes and submits claim 📝
  ⬇️

• Insurance company reviews claim 🔍
  ⬇️

• Insurance sends Explanation of Benefits (EOB) 📋
  ⬇️

• Payment is made or claim is denied 💵❌

​Receiving Payments as a HI worker💰

• Provider bills patient for charges insurance doesn’t cover 🧾

• Copayments (copays): Paid at time of service ⏰

• Out-of-pocket fee for covered services like visits or prescriptions 💊

• Collect copays by cash, check, or card 💵💳

• Always provide a receipt 🧾

Multiple Select

What can happen if a patient’s medical chart is not coded properly? (choose all that apply)

• The provider will be reimbursed at the correct rate.

• Errors in records can also affect research, public health, and patient care

• The patient may be overcharged/undercharged.

Match

Match the following:

• Shows what insurance pays, what it doesn’t, and why.

• Steps to submit medical costs for payment or denial.

• Out-of-pocket fee Fee paid by the patient at the time of a covered service.

Explanation of benefits (EOB)

Claims Process

Copay

• Explanation of benefits (EOB)

• Claims Process

• Copay