Computer assisted coding (CAC). Another new type of application uses natural language processing to help hospital coders pick the correct codes for a given office visit, test or procedure. CAC does this by extracting code-related terms from electronic text to supplement the coded elements in the EHR's structured fields. It has been shown to improve productivity by automating parts of the coding process. In outpatient departments such as radiology and pathology, CAC can automate most of the coding, but more human intervention is required in inpatient coding. CAC is expected to grow in importance after the advent of ICD-10 coding in October 2015 (see the regulatory section).
Electronic payment posting and funds transfer. Electronic payment posting is a feature of most practice management/hospital financial systems. When electronic remittance advice (ERA) comes into the system from a health plan, it can automatically post a payment to the account. This is a great time saver and is much more accurate than manual posting. Denial management staff can also use the ERA to pinpoint problems in denied claims so they can correct and resubmit them. Many insurers also transfer payments automatically to providers' bank accounts, speeding up their cash flow. For this system to work properly, payment posting and ETF must be in synch with each other.
Patient cost accounting systems. Cost accounting systems in hospitals record, analyze, and allocate costs to the individual services provided to patients, such as medications, procedures, tests, and room and board. These systems were once considered optional in healthcare. But in recent years, as value-based reimbursement has gathered momentum, most hospitals have started looking hard at their cost structure, from labor to supply chain costs. Physician costs are often measured in "relative value units," which assign work values to particular professional services based on an agreed-upon national formula. Hospitals usually analyze their costs and revenues within departments such as cardiology and surgery or service lines such as heart centers and maternity centers.
Patient scheduling systems. Patient scheduling, known as registration on the hospital side, goes beyond simple appointment booking. For new patients, this is the part of the process in which "patient demographics" – including name, contact information, age, sex, and insurance – are documented. In some organizations, schedulers verify insurance at this stage, before the patient arrives at the healthcare facility. There are separate ambulatory care and inpatient registration systems, and most hospitals also have surgical scheduling systems. Because no-shows can be costly to healthcare providers, scheduling systems may be connected to third-party reminder systems that send automated phone messages to patients prior to office visits or scheduled tests or procedures.
Practice management (PM) systems. Most physician practices have PM systems that they use for scheduling, billing and financial accounting. Originally standalone, these systems were later integrated with EHRs and exchanged billing and patient demographic data across those interfaces. That is still true of less expensive EHRs and PM systems, but the leading vendors now integrate the clinical and practice management sides in a single application. That approach allows billing people, for example, to review clinical notes for coding purposes. Hospital financial systems are separate from the PM systems of hospital-owned practices, but the hospital's central business office often handles billing and scheduling for those practices.
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