Introduction to Health Information Management

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A health information system is a set of tools designed to allow rapid access to timely information on the health status or refers to any system that captures, stores manages or transmits information related to the health of individuals or the activities of organizations that work within the health sector.

Problems facing billing issues and health information management

The health information system has been mired with allegations of with fraud and abuse in the past since they were proper record keeping but in the recent introduction of electronic health record (EHR) program is changing the way providers capture documentation on the front end despite this many physicians are complaining that it takes longer to document an encounter in an EHR than it was previously.

Identifying and correcting inconsistencies within the same note like for example the physician may indicate the patent is pain level was at level 5 in the history of present illness and in the exam documentation that the patient was in no pain.

The other challenge all physicians is the implementation of ICD-10. Known as a super-granulated coding system, ICD-10 which requires some massive rewriting of EHR templates to ensure sufficient documentation is present to code the service. Some consultants are anticipating the detailed documentation required to select an ICD-10 code may decrease productivity by up to 50 percent for both physicians and HIM professionals.

Neglecting to inform patients about financial responsibility spells collection issues. The main goal of medical billing is to collect the full amount for services rendered, but many healthcare organizations have recently experienced more issues with collecting payments from patients because of an increase in patient financial responsibility this has impacted the patients negatively in the community which leads to inconveniences of the patient expenditure.

Manual claims management processes create an administrative burden. As most healthcare organizations know, submitting a claim involves more than just pushing a button. Providers must engage robust data collection tools, develop effective communication channels between front-end and clinical staff, and streamline denials management procedures. Management is a complex process for the entire healthcare organization, especially as more providers transition to data-driven value-based care models

Inaccurate coding remains a top medical billing error. While ICD-10 implementation went smoother than expected for most healthcare organizations, coding inaccuracies are still a significant challenge for many providers. The American Health Information Management Association (AHIMA) identified the top coding challenges, including incorrectly applying the seventh characters for trauma and fracture codes, improperly using procedure codes that drive a diagnostic related group, misidentifying respiratory failure, mistaking the use of guidance tools, and insufficiently documenting devices, components, and grafting materials.

Failure to capture patient information leads to claims reimbursement delays. The medical billing process usually starts at the initial point of contact between a patient and a healthcare organization. During this interaction, front-end staff must collect patient information that will lay the foundation for billing and collecting.

Getting the most accurate information up front starts with patient scheduling and patient registration. That provides the groundwork for which claims can be billed and collected in the most efficient and effective manner possible. All the health facilities and healthcare professionals must understand and comply with a wider range of legal and ethical standards as new e-health applications are created and evolve, healthcare professionals must collaborate with the federal government, communities legislators medical technology professionals and consumers.

Works cited

Berg, Marc. "Implementing information systems in health care organizations: myths and challenges." International journal of medical informatics 64.2-3 (2001): 143-156.

Wager, Karen A., Frances W. Lee, and John P. Glaser. Healthcare information systems: a practical approach for healthcare management. John Wiley & Sons, 2017.