INTEGRATED MEDICAL SOFTWARE SYSTEM WITH PATIENT PRE-APPROVALS
An integrated medical software system with a patient registration software component executed by a processor of the system to capture patient information is disclosed. The system and method comprise a section where demographic data is input for the patient, said demographic data including at least one of a digital photograph, a name, an address, a date of birth, a social security number, and a sex of the patient; a section where financial data is input for the patient, said financial data including at least one of financial responsibility, outstanding balances, insurance coverage, insurance claims currently being processed, and account information of the patient; and a section where administrative data is input for the patient, said administrative data including at least one of scheduling information, reminders and alerts, visit check-in and check-out, and system preferences for the patient, wherein the patient is pre-approved for at least one of a referral, a hospital admission, a clinician's order, a medical procedure, or a medication that would otherwise require prior approval based on at least one of the demographic data, the financial data, and the administrative data.
1 - 62 . (canceled)
63 . An integrated medical software system with a patient registration software component executed by a processor of the system to capture patient information, the registration component comprising:
a section where demographic data is input for the patient, said demographic data including at least one of a digital photograph, a name, an address, a date of birth, a social security number, and a sex of the patient;
a section where financial data is input for the patient, said financial data including at least one of financial responsibility, outstanding balances, insurance coverage, insurance claims currently being processed, and account information of the patient; and
a section where administrative data is input for the patient, said administrative data including at least one of scheduling information, reminders and alerts, visit check-in and check-out, and system preferences for the patient,
wherein the patient is pre-approved for at least one of a referral, a hospital admission, a clinician's order, a medical procedure, or a medication that would otherwise require prior approval based on at least one of the demographic data, the financial data, and the administrative data.
64 . The integrated medical software system of claim 63 , wherein the registration component further comprises a section where the patient's demographic data, financial data, and administrative data is retrieved via that patient's digital photograph.
65 . The integrated medical software system of claim 63 , wherein the registration component further comprises a section where the patient's electronic chart is launched for viewing.
66 . The integrated medical software system of claim 63 wherein the registration component further comprises a section where one or more insurance plans are associated with an employer so that any patient that is employed by the employer can be associated with the one or more insurance plans via the employer instead of entering detailed insurance information for each of those patients.
67 . The integrated medical software system of claim 63 , further comprising:
a database for storing demographic data, financial data, administrative data, and clinical data in a normalized data format;
a clinical module that creates an electronic document and that captures clinical data for a patient in the electronic document in the normalized data format during an encounter with the patient, said electronic document being pre-populated with at least a portion of the patient's demographic data;
an account management module that captures financial data in the normalized data format and that automatically creates at least one of a bill, a claim, and a statement for the patient using the financial data and the clinical data;
a scheduling module that captures administrative data in the normalized data format and that schedules the patient and at least one of a clinician, a staff member, and equipment at a healthcare provider using the scheduling data and the administrative data; and
a framework module that is integrated with the patient registration component, the clinical module, the account management module, and the scheduling module using a common architecture and that supports an exchange of the clinical data, the demographic data, the financial data, and the administrative data between those modules, the registration component, and the database in the normalized data format.
68 . The integrated medical software system of claim 67 , wherein at least one of the demographic data, the financial data, and the administrative data is updated based on input from at least one of the account management module, the scheduling module, and the clinical module.
69 . The integrated medical software system of claim 63 , wherein at least one of the demographic data, the financial data, and the administrative data is imported from an external system via electronic conversion.
70 . The integrated medical software system of claim 63 , wherein the demographic data and the financial data include all of the data required by the Centers for Medicare and Medicaid Service for use in an EDI (Electronic Data Interchange) environment.
71 . The integrated medical software system of claim 63 , wherein at least one of the demographic data, the financial data, and the administrative data is input by administrative staff at the healthcare provider.
72 . The integrated medical software system of claim 63 , wherein at least one of the demographic data, the financial data, and the administrative data is input by the patient with a user interface at a waiting room kiosk at the healthcare provider or remotely via a secure Internet connection.
73 . A method for registering patients with an integrated medical software system, said method being embodied on a processor-executable medium and said integrated medical software system having a processor that executes the method to perform the steps of:
receiving demographic data for the patient, said demographic data including at least one of a digital photograph, a name, an address, a date of birth, a social security number, and a sex of the patient;
receiving financial data for the patient, said financial data including at least one of financial responsibility, outstanding balances, insurance coverage, insurance claims currently being processed, and account information of the patient;
receiving administrative data for the patient, said administrative data including at least one of scheduling information, reminders and alerts, visit check-in and check-out, and system preferences for the patient; and
pre-approving the patient for at least one of a referral, a hospital admission, a clinician's order, a medical procedure, or a medication that would otherwise require prior approval based on at least one of the demographic data, the financial data, and the administrative data.
74 . The method of claim 73 , further comprising the step of providing access to the patient's demographic data, financial data, and administrative data via that patient's digital photograph.
75 . The method of claim 73 , further comprising the step of launching the patient's electronic chart from a registration screen for viewing.
76 . The method of claim 73 , further comprising the step of associating one or more insurance plans with an employer so that any patient that is employed by the employer can be associated with the one or more insurance plans via the employer instead of entering detailed insurance information for each of those patients.
77 . The method of claim 73 , further comprising the steps of:
creating an electronic document, pre-populating the electronic document with at least a portion of the patient's demographic data, and capturing clinical data for the patient in the electronic document in a normalized data format during an encounter with the patient;
capturing financial data in the normalized data format and automatically creating at least one of a bill, a claim, and a statement for the patient using the financial data and the clinical data;
capturing administrative data in the normalized data format and scheduling the patient and at least one of a clinician, a staff member, and equipment at the healthcare provider using the administrative data and the demographic data; and
storing the patient's demographic data, financial data, administrative data, and clinical data in a database in the normalized data format,
wherein the system is built on a common architecture to support an exchange of the demographic data, the clinical data, the financial data, and the administrative data in the normalized data format as required to perform each of the steps.
78 . The method of claim 77 , further comprising the step of updating at least one of the demographic data, the financial data, and the administrative data as that data is received during a corresponding step of receiving.
79 . The method of claim 73 , further comprising the step of importing at least one of the demographic data, the financial data, and the administrative data from an external system via electronic conversion.
80 . The method of claim 73 , wherein the demographic data and the financial data include all of the data required by the Centers for Medicare and Medicaid Service for use in an EDI (Electronic Data Interchange) environment.
81 . The method of claim 73 , wherein at least one of the demographic data, the financial data, and the administrative data is received as input from administrative staff at the healthcare provider.
82 . The method of claim 73 , wherein at least one of the demographic data, the financial data, and the administrative data is received as input from the patient via a user interface at a waiting room kiosk at the healthcare provider or remotely via a secure Internet connection.