Florida National University Medisoft Clinical Software Paper

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Computer Science

Florida National University

Description

Chapter 3.

Medisoft Clinical is a robust electronic medical record software solution for independent practices:

1-Discuss three security features in Medisoft Clinical that protect patients’ health information.

2-Explain the types of help available in Medisoft Clinical.

3-Describe how encounter tasks are completed in Medisoft Clinical.

4-Explain how to create and restore backup files in Medisoft Clinical

5- List the menus in Medisoft Clinical Patient Records.

Chapter 4.

Scheduling aims to improve the match between healthcare resources (doctors, nurses, rooms, equipment, medicines) and patient needs. A good scheduling system reduces waits for patients while also improving the utilization of critical resources.

1- Describe the two methods used to schedule appointments.

2-Explain the method used to classify patients as new or established.

3- How you can Identify the information that needs to be verified for established patients when making an appointment?

4-Explain when a preauthorization number or referral document is required for a patient’s encounter.

5-Describe how to enter an appointment.

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CHAPTER 4 Scheduling McGraw-Hill © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-2 Learning Outcomes When you finish this chapter, you will be able to: 4.1 4.2 4.3 4.4 4.5 Describe the two methods used to schedule appointments. Explain the method used to classify patients as new or established. List the three categories of information new patients provide during telephone preregistration. Identify the information that needs to be verified for established patients when making an appointment. Describe covered and noncovered services under medical insurance policies. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-3 Learning Outcomes (Continued) When you finish this chapter, you will be able to: 4.6 4.7 4.8 4.9 4.10 4.11 List the three main points to verify with the payer regarding a patient’s benefits prior to a visit. Explain when a preauthorization number or referral document is required for a patient’s encounter. List the four main areas of Medisoft Network Professional’s Office Hours window. Demonstrate how to enter an appointment. Demonstrate how to book follow-up and repeating appointments. Demonstrate how to reschedule an appointment. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-4 Learning Outcomes (Continued) When you finish this chapter, you will be able to: 4.12 4.13 4.14 Demonstrate how to create a recall list. Demonstrate how to enter provider breaks in the schedule. Demonstrate how to print a provider’s schedule. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-5 Key Terms • • • • • • • • • • • benefits capitation coinsurance copayment (copay) covered services deductible established patient (EP) fee-for-service health plan indemnity plan managed care • • • • • • • • • medical insurance new patient (NP) noncovered services nonparticipating (nonPAR) provider Office Hours break Office Hours calendar Office Hours patient information out-of-network out-of-pocket © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-6 Key Terms (Continued) • participating (PAR) provider • patient portal • payer • policyholder • preauthorization • preexisting condition • premium • preregistration • preventive medical services • • • • • • provider provider’s daily schedule provider selection box referral referral number schedule of benefits © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-7 4.1 Scheduling Methods • Patient appointments may be scheduled via telephone or online. • Patient portal—secure website that enables communication between patients and health care providers for tasks such as scheduling, completing registration forms, and making payments © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.1 Scheduling Methods (Continued) 4-8 • Scheduling systems include these methods: – – – – Open hours Stream scheduling Double-booking Wave scheduling © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.2 New Versus Established Patients 4-9 • New patient (NP)—patient who has not received professional services from a provider (or another provider with the same specialty in the practice) within the past three years • Established patient (EP)—patient who has received professional services from a provider (or another provider with the same specialty in the practice) within the past three years • Preregistration—process of gathering basic contact, insurance, and reason for visit information before a new patient comes into the office for an encounter © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.3 Preregistration for New Patients 4-10 • During preregistration, new patients usually provide three types of information: – Demographic information – Basic insurance information – Reason for the visit (also known as the chief complaint) © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.3 Preregistration for New Patients (Continued) 4-11 • Participating (PAR) provider—provider who agrees to provide medical services to a payer’s policyholders according to the terms of the plan’s contract • Nonparticipating (nonPAR) provider— provider who chooses not to join a particular government or other health plan © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.4 Appointments for Established Patients 4-12 • Medical offices verify established patients’ information prior to an appointment; such information includes: – changes to a patient’s address, – changes to a patient’s health plan or employment. • The reason for the visit should also be established to schedule the correct amount of time for the encounter. • Patients’ account balances are checked as well. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics 4-13 • Medical insurance—financial plan that covers the cost of hospital and medical care • Policyholder—person who buys an insurance plan; the insured, subscriber, or guarantor • Health plan—individual or group plan that either provides or pays for the cost of medical care • Payer—health plan or program • Premium—money the insured pays to a health plan for a health care policy; usually paid monthly © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-14 • Benefits—amount of money a health plan pays for services covered in an insurance policy • Schedule of benefits—list of the medical expenses that a health plan covers • Provider—person or entity that supplies medical or health services and bills for or is paid for the services in the normal course of business © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-15 • Covered services—medical procedures and treatments that are included as benefits under an insured’s health plan – These may include primary care, emergency care, medical specialists’ services, and surgery. • Preventive medical services—care that is provided to keep patients healthy or to prevent illness, such as routine checkups and screening tests © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-16 • Noncovered services—medical procedures that are not included in a plan’s benefits; these things may include: – Dental services, eye care, treatment for employmentrelated injuries, cosmetic procedures, infertility services, or experimental procedures – Specific items such as vocational rehabilitation or surgical treatment of obesity – Prescription drug benefits – Treatment for preexisting conditions—illnesses or disorders of a beneficiary that existed before the effective date of insurance coverage © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-17 • Indemnity plan—type of medical insurance that reimburses a policyholder for medical services under the terms of its schedule of benefits • Deductible—amount that an insured person must pay, usually on an annual basis, for health care services before a health plan’s payment begins • Coinsurance—portion of charges that an insured person must pay for health care services after payment of the deductible amount; usually stated as a percentage © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-18 • Out-of-pocket—expenses the insured must pay before benefits begin • Fee-for-service—health plan that repays the policyholder for covered medical expenses • Capitation—prepayment covering provider’s services for a plan member for a specified period © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-19 • Managed care—system that combines the financing and delivery of appropriate, costeffective health care services to its members; basic types include: – – – – Health maintenance organizations (HMOs) Point-of-service (POS) plans Preferred provider organizations (PPOs) Consumer-driven health plans (CDHPs) • Out-of-network—provider that does not have a participation agreement with a plan © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.5 Insurance Basics (Continued) 4-20 • Preauthorization—prior authorization from a payer for services to be provided • Copayment (copay)—amount that a health plan requires a beneficiary to pay at the time of service for each health care encounter • Referral—transfer of patient care from one physician to another © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.6 Eligibility and Benefits Verification 4-21 • Except in a medical emergency, the following information should be obtained/verified from a patient’s health plan before an encounter: – Patient’s general eligibility for benefits – Amount of the copayment for the visit, if one is required – Whether the planned encounter is for a covered service that is medically necessary under the payer’s rules • Patients should be informed if their policy does not cover a planned service. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.7 Preauthorization, Referrals, and Outside Procedures 4-22 • Managed care payers often require preauthorization before a patient: – sees a specialist, – is admitted to the hospital, or – has a particular procedure. • If the payer approves the service, it issues a preauthorization number that must be entered in the PM and included on the claim. • Referral number—authorization number given by a referring physician to the referred physician © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.8 Using Office Hours—Medisoft Network Professional’s Appointment Scheduler 4-23 The Office Hours window contains four main areas: – Provider selection box—selection box that determines which provider’s schedule is displayed in the provider’s daily schedule – Provider’s daily schedule—listing of time slots for a particular day for a specific provider that corresponds to the date selected in the calendar – Office Hours calendar—interactive calendar that is used to select or change dates in Office Hours – Office Hours patient information—area that displays information about the patient who is selected in the provider’s daily schedule © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-24 4.9 Entering Appointments To enter an appointment in Medisoft Clinical: – Select the appropriate provider from within the Office Hours program. – Choose an appointment time slot. – Complete the fields in the New Appointment Entry dialog box. – Click the Save button to enter the information on the schedule. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.10 Booking Follow-up and Repeating Appointments 4-25 • To create follow-up appointments in Office Hours: – Click the Go to a Date shortcut button on the toolbar; the Go To Date dialog box will be displayed to allow a choice of date. – After a future date option is selected, click the Go button to close the dialog box and begin the search. – The future date will be located and displayed in the calendar schedule accordingly. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.10 Booking Follow-up and Repeating Appointments (Continued) 4-26 • To create repeating appointments in Office Hours: – Open the New Appointment Entry dialog box. – Click the Change button; the Repeat Change dialog box is displayed. – Make selections and enter information in the Repeat Change dialog box. – When done, click the OK button, and then the Save button, to enter the repeating appointments on the schedule. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.11 Rescheduling and Canceling Appointments 4-27 To locate an appointment that needs to be rescheduled: – Click the Appointment List option on the Office Hours Lists menu; the Appointment List dialog box appears. – Use the Cut and Paste commands to move an appointment. – Use the Cut command to cancel an appointment. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4.12 Creating a Patient Recall List 4-28 To create or maintain a recall list in MNP: – Click Patient Recall on the Lists menu; the Patient Recall List dialog box is displayed. – Patients are added to the recall list by clicking the New button in the Patient Recall List dialog box or by clicking the Patient Recall Entry shortcut button; the Patient Recall dialog box is displayed. – After the information has been entered in the dialog box, click the Save button. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-29 4.13 Creating Provider Breaks • Office Hours break—block of time when a physician is unavailable for appointments with patients • To set up a break for a current provider: – Click the Break Entry shortcut button; the New Break Entry dialog box will appear. – Enter the information in the dialog box, and click the Save button to enter the break(s). © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 4-30 4.14 Printing Schedules • To print a provider’s schedule within Office Hours: – Use the Appointment List option on the Office Hours Reports menu to view a list of all appointments for a provider for a given day. – The report can be previewed on the screen or sent directly to the printer. • Alternatively, click the Print Appointment List shortcut button. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. CHAPTER 3 Introduction to Medisoft Clinical McGraw-Hill © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3-2 Learning Outcomes When you finish this chapter, you will be able to: 3.1 3.2 3.3 3.4 3.5 3.6 List the practice management and electronic health record applications in Medisoft Clinical. Discuss three security features in Medisoft Clinical that protect patients’ health information. List the menus in Medisoft Clinical Patient Records. List the menus in Medisoft Network Professional. Describe how pre-encounter tasks are completed in Medisoft Clinical. Describe how encounter tasks are completed in Medisoft Clinical. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3-3 Learning Outcomes (Continued) When you finish this chapter, you will be able to: 3.7 3.8 3.9 Describe how post-encounter tasks are completed in Medisoft Clinical. Explain how to create and restore backup files in Medisoft Clinical. Discuss the types of help available in Medisoft Clinical. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3-4 Key Terms • • • • • • • • • • access levels Auto Log Off backing up chart chief complaint dashboard database disaster recovery plan knowledge base Medisoft Clinical • Medisoft Clinical Patient Records (MCPR) • Medisoft Network Professional (MNP) • park • password • restoring • user name © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.1 Medisoft Clinical: A Practice 3-5 Management/Electronic Health Record Program • Medisoft Clinical—integrated practice management (PM) and electronic health record (EHR) program • Medisoft Network Professional (MNP)— practice management application within Medisoft Clinical • Medisoft Clinical Patient Records (MPCR)— electronic health record application within Medisoft Clinical © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.2 Security Features in Medisoft Clinical 3-6 Medisoft Clinical has a number of built-in security features • User name—name that an individual uses for identification purposes when logging onto a computer or an application • Password—confidential authentication information • Access levels—security option that determines the areas of the program a user can access, and whether the user has rights to enter or edit data © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.2 Security Features in Medisoft Clinical (Continued) 3-7 • Park—privacy and security feature in MPCR that allows a user to leave a workstation for a brief time without having to exit the program • Auto Log Off—feature of MNP that automatically logs a user out of the program after a period of inactivity © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.3 Medisoft Clinical Patient Records 3-8 • Standard menu items in MCPR include: – – – – – – – File View Task Maintenance Reports Window Help © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.3 Medisoft Clinical Patient Records (Continued) 3-9 • Database—collection of related bits of information • Chart—folder that contains all records pertaining to a patient • Dashboard—panel in MCPR that offers providers a convenient view of important information © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.4 Medisoft Network Professional 3-10 • Names of the menus in MNP are listed on the menu bar, and include: – – – – – – – – File Edit Activities Lists Reports Tools Window Help © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.5 Using Medisoft Clinical to Complete Pre-Encounter Tasks 3-11 • Pre-encounter steps include preregistration and appointment scheduling. – To enter preregistration information about a new patient, click the New Patient button, and complete the Patient/Guarantor dialog box. – To enter an appointment in Office Hours, select a provider, select a date and time slot, and save. • Chief complaint—patient’s description of the symptoms or reasons for seeking medical care © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.6 Using Medisoft Clinical to Complete Encounter Tasks 3-12 • Encounter steps include all activities that take place from the patient’s arrival until the patient’s departure from the office, such as: – Establishing financial responsibility—real-time insurance eligibility can be checked • Insurance information is entered in one or more of the Policy tabs in the Case folder in MNP. – Check-in—reviewing account balance, updating patient information, recording documentation and examination findings • The Patient/Guarantor dialog box is updated as needed. • SOAP notes are recorded. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.6 Using Medisoft Clinical to Complete Encounter Tasks (Continued) 3-13 • Encounter steps (continued): – Coding—assigning codes based on the services provided and the provider’s determination • In MPCR, codes are selected from lists provided on an electronic encounter form. – Checkout—payments are calculated and posted, follow-up appointments and tests are scheduled, materials are dispensed, and referrals are provided • The Unprocessed Charges dialog box in MCPR is used to post and review charges. • Scheduling is performed in Office Hours. • Referral and prescriptions are created within MCPR. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.7 Using Medisoft Clinical to Complete Post-Encounter Tasks 3-14 • After the patient visit is complete, activities focus on payment for services, including: – Preparing and transmitting claims • In MNP, claim functions are located on the Activities menu. • The Claim Management dialog box is used for current claims and to create new claims. • Claims are transmitted through MNP’s Revenue Management feature. – Monitoring payer adjudication • Payer adjudication is tracked using the Deposit List window. • Charges are applied in the Apply Payment/Adjustment to Charges dialog box. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.7 Using Medisoft Clinical to Complete Post-Encounter Tasks (Continued) 3-15 • Activities focused on payment for services (continued): – Generating patient statements • In MNP, the Statement Management option on the Activities menu contains options for creating and printing patient statements. • Selections in the Create Statements dialog box determine which statements will be created. – Following up on payments and collections • In MNP, collection functions are located on the Activities menu and on the Reports Menu. • The Collection List feature on the Activities menu is used to place an account in collections. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.8 Backing Up and Restoring Files 3-16 • Disaster recovery plan—plan for resuming normal operations after a disaster such as a fire or a computer malfunction • Backing up—making a copy of data files at a specific point in time that can be used to restore data – In MNP, the Backup Data option on the File menu can be used to make a backup copy of the database. • Restoring—process of retrieving data from a backup storage device – Files are restored using the Restore Data feature on the File menu. © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 3.9 The Medisoft Clinical Help Feature 3-17 • MNP and MCPR offer built-in and online help files. – Built-in help feature is accessed via the Help menu. – Help menu also provides access to help available online at the MNP website. • Knowledge base—collection of up-to-date technical information © 2012 The McGraw-Hill Companies, Inc. All rights reserved.
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Explanation & Answer

Attached.

1

CHAPTER 3 AND 4 Q &A

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Institutional Affiliation
Course Name
Instructor’s Name
Date

2
Chapter 3
Medisoft Clinical is a robust electronic medical record software solution for independent
practices:
Question 1
Medisoft Clinical is an integrated electronic health record (EHR) and practice
management program. It has various distinct and outstanding inbuilt security features that aid in
patients’ health information protection. The first security feature is a username. Each patient has
a unique user name. This specific user name is a necessity for logging in onto the application or
computer (Sanderson, 2012).
The second Medisoft Clinical’s key security feature is a password. A password is a
unique combination of symbols, letters, and numbers. It is confidential authentication
information that only enables the authorized person to access a patient’s information. The last
security feature of the Medisoft Clinical that aids protect patients’ information is access levels.
The software has various distinct levels. The levels dictate the users’ rights to edit and enter data
and limit the content and areas a user can access (Sanderson, 2012).
Question 2
The Medisoft Clinical software is composed of Medisoft Network Professional (MNP),
an application that aids in practice management and Medisoft Clinical Patient Records (MCPR),
an a...


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