Health Care Terms Essay

1224 words - 5 pages



Health care Terms

HSC/533

Health care Terms
Efforts from the health care industry to enter into the world of technology often called the Health Information technology (HIT). HIT enhances the quality of health care, protection, and a resourceful health care delivery system. The information exchange between government, insurers, customers, and suppliers is secure. The defining of the terms and their importance form the foundation of beginning to understanding the health care industry and some of the terms include CMR, CMS, CMS-1500, CPT, and others.

AMR

Automated Medical Records the information was done on a personal computer and did not meet the standards for ...view middle of the document...

The important part about the CMS center they can retrieve large amounts of information so that health care facilities can analyze the data at any time and create graphs (Wager, Lee, & Glaser, 2009).

CMS-1500

CMS-1500 the Center for Medicare and Medicaid services and other payers use this as one of two Uniform Billing for the services provided by the health care provider. The CMS-1500 uses the information from insurance claim forms for analyzing health care reimbursements along with the clinical trends and data used for analyzing the state’s health information. Created by American Medical Association and maintained by the National Uniform Claim Committee and used for billing from non-institutional provider claims. The new form records the NPI number separately in a different box and keeping everything together decreases the confusion and the incomplete forms (Wager, Lee, & Glaser, 2009).

CPT

CPT Current Procedural Terminology the codes that are assigned to every procedure or service provided by the medical, surgical, and diagnostic services. These five digit codes determine the reimbursement, and are uniformly, and each year the AMA publishes an updated CPT. The first category concerns the services performed by several doctors at different locations. The second category – Performance Measurement Establishes evidence-based measurements, measurements currently in use in health care, addresses the issues of the risks and costs involved. The third category- emerging technology consists of the protocol of procedures performed, support from users of the procedure, peer-reviewed literature, and descriptions of current trials outlining efficacy of procedures. Without the CPT reimbursement would not be possible for the doctor’s office, outpatient or ambulatory care (Wager, Lee, & Glaser, 2009).

DRG

DRG or Diagnosis Related Groups a hospital system that classified as grouper program that supported by the ICD diagnosis, cause of action, sex, age, and similar factors. This system determines the specific reimbursement based on the diagnosis of the patient. The hospital code system places the hospital cases into one of 500 groups for effective management there is many DRG systems in the United States but Medicare only uses one MS-DRG. This determines the amount that Medicare pays the hospital for the services that the hospital offers, and developed exclusively for Medicare and the future payment system (Wager, Lee, & Glaser, 2009).

EPR

EPR Electronic Patient Records these computer files contain the vital past and present medical information on each patient. Several reasons for the change from paper files to the electronic files, such as the efficiency, easier transfer, no mistakes in directions, and cost-efficient, and the medical profession can access the patient information from anywhere and anytime. Whereas, improving the quality of patient care, and a reduction in medical errors, and the ability to identify an...

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