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Re: [Gnumed-devel] Introducing myself and questions on billing/accountin


From: Jim Busser
Subject: Re: [Gnumed-devel] Introducing myself and questions on billing/accounting
Date: Thu, 19 May 2011 21:41:01 -0700

On 2011-05-19, at 5:05 PM, Jim Busser wrote:

> On 2011-05-19, at 4:36 PM, Chris Travers wrote:
> 
>> Currently LSMB doesn't even support purging old data. 
> 
> Don't in any way apologize… there is a lot to be said for data integrity. 
> Also, the accounting records are unlikely to b individually large as I do not 
> imagine that accounting much stores large image or sound or video files!

So… what more remains to be clarified before some schematizing and/or 
prototyping might be able to begin?

> 1)  Where should the data be entered?

        I think we agreed to accept flexibility

        - where clinically relevant, in the EMR
        - where not clinically relevant, directly in billing/accounting software
        - clinic gets to decide what is clinically relevant

> 2)  Who reviews that data?

        I think we agree it should be
        - the biller / accounts manager
        - working and viewing from the billing / accounting software
        - with some sane way to acquire clinical information as needed to 
support payment
                - EMR may push it
                - billing ./ accounting daemon / service might be allowed to 
query it
                - failing the above the MOA or doctor might have to manually 
provide it

> 3)  How does it get sent out as an insurance claim or patient bill?

        This is maybe where Chris was wondering about whether & how to support 
on-line claiming?

        --> suggest see this page, second section ("Q & A with a Mediclaim 
developer")
                http://wiki.gnumed.de/bin/view/Gnumed/BillingBritishColumbia

        --> re insurer's data specification requirements:

                yes, this could be integrated to be pushed out *by* the EMR

                *or*

                it could be integrated into the accounting program provided it 
would be granted an EMR user account that would permit a daemon / background 
process to fetch the needed data from the schema… yes??




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