Term
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Definition
| integration of services that allow for accurate and completed data collection and satisfaction of prerequisites prior to a healthcare encounter or at the time of an unscheduled encounter;ensure appropriate follow-up to assure data integrity;integrates the data collection necessary for integiry, clinical care and discharge planning processes and continually monitors for complete and accurate date; provide and assure accuracy in statistical reporting;Allow for the management of confidential communication of pertinent data throughout the continum of care to elimiate repetittive questioning; Encourage personalized care and service to patients, family, visitors physicians, and other providers in the continum of care; Value and respect all persons who support the provision of health care service while empowering and motivating everyone to address customer needs |
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Term
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Definition
| Pre-Encounter, Encounter, Future Development |
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Term
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Definition
Customer and Referal Services, Patient Assessment, Resource Scheduling, Preregistration, Patient & Family Education, Clinical prerequisites, Financial Prerequisites, Payor Authorizations, Verification of benefits, Pre-encounter communication
Continuum: physician care provider communications, care management, aftercare |
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Term
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Definition
Patient placement, patient check-in admission registration, patient tracking, concierge services, transport/routing coordination, wayfinding, information, family liaison services, order entry, ADT transactions, Departure, Charge capture, Census management, Billing
Continuum: Customer Service, Data Integrity, Performance Improvement, Information Sharing |
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Term
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Definition
Physician relations, Productivity and accuracy, Staff education and competency, Benchmarking, Customer satisfaction, Statistical Reporting, Resource Management
Continuum: Compliance, Marketing, Plan membership services, Data Management, Service Integration |
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Term
| Customer and Referral Services |
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Definition
| Pre-Encounter: Process by which patients are referred to a health care provider. Goal is to attain and maintain quality service and high levels of customer satisfaction as well as sustain the referral flow. |
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Term
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Definition
| Pre-Encounter: Review of patients needs and expectations for service to be provided. Review will have both a clinical and a financial focus and should include discussions about possible alternative options for care and after care planning. The review will result in the development and documentation of a plan (written and/or oral) for the patient and family. |
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Term
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Definition
| Pre-Encounter: Receipt of a request to arrange a place, equipment and/or person(s) for a defined date and time. Includes, but is not limited to, physician appointments, ancillary services, operating room and inpatient beds. Confirmation of availability of service and actual scheduling of service will follow the request. Documentation of the scheduled services will provide communication to all involved parties. |
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Term
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Definition
| Pre-Encounter: The collection, dissemination and storage of registration ifnormation, including demographic, financial, and clinical data, prior to the patient's arrival |
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Term
| Patient and Family Education |
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Definition
| Patient's education program is planned utilizing the results of the patient assessment. Plan includes: a determination of avilable materials and appropriate teaching tools and methods, the timing of the teaching and the audience (i.e. family as well as patient), age specific criteria, as well as the content/information the patient needs. Feedback is sought from the patient and family to insure comprehension and understanding. |
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Term
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Definition
| Pre-Encounter: The determination of required clinical prerequisites for planned healthcare service is obtained from physician orders and other established protocols. Clinical prerequisites include, but are not limited to, preps and testing. The procedures must be communicated to the patient and/or family to insure timely completion and compliance with the requirement. Collection and review fo previous testing results is required prior to the service being rendered. |
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Term
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Definition
| Pre-Encounter: Assuring that all the appropriate payors ahve been identified, their requirements have been met, and there has been communication with the patient about their financial obligations prior to service. |
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Term
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Definition
| Approval from third party payors to provide specified care in a particular setting; written or electronic assurance that the services provided will be covered under the terms of the patients healthcare plan |
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Term
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Definition
| Process of confirming benefits for services. Process of verification of deographic, financial and insurance information that is obtained either through pre-registration or scheduling is second in importance only to the process of pre-certification. Truly, the two processes must go hand-in-hand to successfully defend the financial viability of the provider. Contact should be made with the insurance company. Benefits may vary significantly with the diagnosis. Together with pre-certification, verified coverage provides the hospital with essential infromation, in advance, to determine appropriate utilization review needs and alternative financial arrangements required. |
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Term
| Pre-Encounter Communications |
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Definition
| Oral or written information shared with patients, their families, and care providers prior to arrival for service. Includes, but is not limited to: answering questions, providing information on preperations for tests and treatments, directions, scheduling and papintment information, financial arrangements, and phone numbers to call with questions or concerns. |
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