What could the home health agency have done

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Reference no: EM133563748

Critical Thinking Assignment Directions:

Read the following two case studies and answer the questions that follow by writing a 500 - 750 word
review (total for both). You need to complete both case studies.

Case Study 1

Many new assisted living and memory care complexes are being constructed in north Florida due to a significant increase in the population of individuals over age 50. Local medical societies and HCO administrators are actively working with these companies to establish relationships for continuing care services. As director of HIM at a local hospital, Larry Green has been asked to develop a slide presentation on the EHR and patient portals to members of these assisted living complexes and active senior citizens' educational centers.

Since the audience has somewhat limited medical terminology and technology knowledge, he is tailoring the presentation to meet their needs. Within the presentation, Larry stresses the importance of the EHR and the benefits it provides to patients, such as increased communication between providers, enhanced continuity of care, and improved patient safety.

He gives a brief overview and examples of the basic functions such as e-prescribing, CPOE, results management, and public health reporting. Larry also gives a demonstration of the patient portal for his hospital. He shows the audience how they can access their patient information, follow-up on lab test results, monitor their blood pressure or glucose levels, ask questions about prescriptions, request or change appointments, schedule educational or health-monitoring sessions, and address their insurance and account issues.

Larry is aware that confidentiality is a topic of concern. Therefore, he addresses interoperability and secure transmission of data between HCOs and providers in his presentation. He also incorporates the HIPAA confidentiality and security information audience members receive when visiting their physicians. Larry concludes his presentation with a discussion of frequently asked questions, and then he allows a significant amount of time to address any other questions the audience may have.

What kinds of privacy and confidentiality features should patients be aware of?
Discuss how the EHR is making patients safer.

Case Study 2

Louise is an 89-year-old woman who was discharged from the hospital after having a cardiac valve replacement for mitral valve stenosis. After going home, she had home health services for a few weeks. Louise had both Medicare and a secondary insurance. She received a bill requesting payment for the home health services provided. She was prepared to write a check for the total amount. Fortunately, her granddaughter, Marie, a HIM professional, was visiting and reviewed the bill. Marie immediately saw that neither Medicare nor the secondary insurance had been billed. Marie assisted her grandmother by calling the home health agency to discuss the bill. She was told that the home health agency did not have the insurance policy numbers. Marie provided the policy numbers. When she was about to hang-up, the billing office representative told Marie that when Louise received a Medicare Summary Notice from Medicare to call them back to let them know so that they could bill the secondary insurance. Marie explained to them that it was their responsibility to identify this. If Marie had not gotten involved, then Louise would have paid the bill and her insurance companies would never have been billed. Also, Louise would have called the home health agency to ask them to bill the secondary insurer.

Identify how this case applies to the chapter.
What could the home health agency have done in order to prevent this problem.

Reference no: EM133563748

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