Term
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Definition
- Consist of separate software and databases linked into computer network
- Exchange information with other healthcare systems using HL7 or proprietary transaction standard
- Software may be from same or different vendor
- Share common database
- Data records read and updated without need for HL7
- Same vendor also supplies software programs such as registration and billing to work together seamlessly |
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Term
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Definition
- Include financial, human resource, scheduling, and quality management systems
- Provide secondary data that may be used for various purposes |
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Term
| Financial information systems |
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Definition
| Track income, expenses, assets, liabilities |
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Term
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Definition
| Overall accounting system used to produce financial statements and monitor organization’s overall financial health |
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Term
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Definition
| Money owed to the business |
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Term
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Definition
| Used to order supplies and services |
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Term
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Definition
| Manages payments for facility purchases, recurring expenses (rent, utilities) and nonrecurring expenses (maintenance, repairs) |
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Term
| Inventory and materials management |
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Definition
| Works with purchasing, deducting from quantity on hand supplies used and adding to quantity on hand supplies received |
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Term
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Definition
| Administration of employee payroll information and payment of wages, employer taxes, benefits |
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Term
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Definition
| Used to predict annual expected income and expenses |
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Term
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Definition
| Used to attribute direct and indirect costs to various departments |
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Term
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Definition
- Allows for examination and treatment of patients
- Predicts labor and resource needs
- Involves making appointments for length of time appropriate to reason for appointment
- Relies on schedule templates |
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Term
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Definition
- Includes processing doctors’ orders for tests or services, coordinating with respective department, arranging for assistant to transport patient within hospital
- Requires schedule coordinator who handles several different departments |
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Term
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Definition
- Employee scheduling systems used to determine which employees are working when
- Provider scheduling includes blocking doctors’ appointment schedule when doctors are not in the office and arranging for another doctor to “cover” patients; maintains on-call schedule |
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Term
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Definition
- Covers many areas related to hospital operation and patient care provided to patients
- Produces data and reports used for risk analysis and decision support that allow facilities to evaluate appropriateness and effectiveness of medical care |
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Term
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Definition
- Case management and utilization management
- Infection control
- Incident tracking
- Patient relations
- Risk management
- Peer review
- Comparative performance measure systems |
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Term
| Risk Assessment Versus Risk Management |
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Definition
Risk assessment involves analyzing processes and measuring statistical data to identify preventable losses and minimizing their occurrences
Risk management provides organizations with information needed to improve performance and processes and provide safer environment for employees, patients, volunteers, visitors |
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Term
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Definition
- Identifies improper payments made on healthcare claims provided for Medicare beneficiaries and obtaining repayment to Medicare
- Reviews handled by private companies with financial incentives to identify and recoup overpayments |
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Term
| RAC Risk Management Strategy |
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Definition
- Establish committee to handle RAC issues
- Create procedure to track RAC requests and ensure they’re handled within permitted timelines
- Conduct internal assessment to ensure submitted claims meet Medicare rules |
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Term
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Definition
- Ensure claims are as accurate as possible when first submitted
- Ensure requests from recovery audit contractor are handled efficiently, effectively, and according to existing procedures and policies |
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Term
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Definition
General Ledger
Account Receivable
Purchasing
Payroll
Inventory and Materials Management
Cost Accounting
Financial Information Systems
Accounts Payable
Budgeting |
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