Health Informatics: Assignment Week 5
Objective: In this assignment, you are requested to you will describe, analyze and apply the process of creating claims, locating specific claims, methods used to submit electronic claims, and the claim determination process used by health plans.
ASSIGNMENT GUIDELINES (10%):
Students will judgmentally evaluate the readings from Chapter 9 and 10 on your textbook and from the article assigned for week 5. The Purpose of this Administrative and Structural Analysis of an Electronic Health Claim Management is to describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way.
You need to develop a 4-5-page paper long including title page and references page reproducing your understanding and capability to relate the readings to claim management. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words.
2. Your Strategies (50%)
a. Briefly compare the CMS-1500 paper claim and the 837 electronic.
b. Discussion the information contained in the claim management dialog box
c. Analyze the method used to submit electronic claims.
d. Discuss the use of the PM/HER to monitor claims.
3. Conclusion (15%)
Briefly summarize your thoughts & conclusion to this assignment and your appraisal of the articles and Chapter you read. How did these articles and Chapters impact your thoughts about Claim Management? How this Administrative Analysis help you in relation to Claim management in Medisoft.
Evaluation will be based on how clearly you respond to the above, in particular:
a) The clarity with which you present and analyzed the strategies;
b) The depth, scope, and organization of your Administrative Analysis paper; and,
c) Your conclusions, including a description of the impact of these articles and Chapters on any Healthcare Organization.
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