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Relationship between electronic health records-reimbursement

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Explain how using EDI facilitates electronic business transactions in healthcare specifically. [Tip: EDI is not the same as HIE. EDI in healthcare is about claims and eligibility transactions, not clinical care. Describe the transactions and why EDI is more efficient]

Explain how HIPAA changed how health care administrative transactions are transmitted using EDI. [Tip: This is NOT about privacy. The Administrative Simplification Rule under HIPAA mandated the use of EDI transactions and there are required code sets and standards. Discuss these specifically- not the privacy rule!]

Describe the relationship between Electronic Health Records, reimbursement, HIPAA, and EDI transactions. [Tip: This element is not related to privacy or quality of care. HIPAA mandated use of electronic transactions using EDI technology before most healthcare entities had an EMR, so there was a disconnect and a lot of manual data entry to submit claims electronically. How does an EHR improve the billing/coding process and facilitate reimbursement via electronic claims and eligibility transactions?]

Reference no: EM132763436

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