The New Century medical team performs services and medical… The New Century medical team

The New Century medical team performs services and medical… The New Century medical team performs services and medical procedures, which are coded according to the American Medical Association’s Current Procedure Terminology (CPT). CPT codes consist of five numeric digits and a two-digit suffix, and most insurance payers require the codes to be included with billing information. The new system must be able to handle the new ICD-10 procedure coding system, which will be required by the Centers for Medicare & Medicaid Services (CMS) beginning October 1, 2014. ICD-10 codes consist of seven alphanumeric characters, which can be electronically transmitted and received. New Century’s information system must interface with 25 California health insurance providers. The new system represents an opportunity for significant cost saving for New Century, and more convenience for patients, who will be able to go online to update medical information, schedule appointments, and request medical records. During your fact-finding, you learned that the clinic requires various reports, as follows: • Daily appointment list for each provider. The list shows all scheduled appointment times, patient names, and services to be performed, including the procedure code and description. • Daily report call list, which shows the patients who are to be reminded of their next day’s appointments. The call list includes the patient name, telephone number, appointment time, and provider name. • Weekly provider report that lists each of the providers and the weekly charges generated, plus a month-to-date (MTD) and a year-to-date (YTD) summary as well as profit distribution data for the partners. • Monthly patient statement, which includes the statement date, head of household name and address, previous month’s balance, total household charges MTD, total payments MTD, and the current balance. The bottom section of the statement shows activity for the month in date order. For each service performed, a line shows the patient’s name, the service date, the procedure code and description, and the charge. The statement also shows the date and amount of all payments and insurance claims. When an insurance payment is received, the source and amount are noted on the form. If the claim is denied or only partially paid, a code is used to explain the reason. A running balance appears at the far right of each activity line. These reports provide a base understanding of the data within the system. It is your task to parse that information into an ERD and relational model1. provide an example of a possible Entity Relationship Diagram, (Including Primary Key, Foreign Key, attributes, cardinality and modality) Health Science Science Nursing CMIS 564 Share QuestionEmailCopy link Comments (0)

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