Electronic data interchange (EDI) is an effort to help phase out ...

[Charlie]

Electronic data interchange (EDI) is an effort to help phase out paper claims except under extensive appeal circumstances. The result of this initiative is which of the following?
 
  1. Health care providers were forced to install EDI transmission programs in their billing and medical record systems.
  2. A large savings on paper supplies
  3. An increased need for assistive software
  4. A decrease in the denial of claims

Question 2

The Centers for Medicare and Medicaid Services (CMS) mandated all providers, insurers and any middlemen involved in the health care industry submission of claims for reimbursement or registering of care, the verifying of eligibility, the
 
  precertification of services, or any other client- related information to adhere to a uniform format by October 2002. This action forced all providers to install____________ ___________ transmission programs in their billing and medical record systems. Fill in the blank(s) with correct word

[Perkypinki]

Answer to Question 1

1
Rationale: This action forced all providers to install EDI transmission programs in their billing and medical record systems by buying practice management systems (PMS) or utilizing a clearinghouse that screened and then transmitted electronic claims and records to the various insurance companies.

Answer to Question 2

Electronic Data Interchange (EDI)
Rationale : The Centers for Medicare and Medicaid Services (CMS) mandated all providers, insurers and any middlemen involved in the health care industry submission of claims for reimbursement or registering of care, the verifying of eligibility, the precertification of services, or any other client- related information to adhere to a uniform format by October 2002. This action forced all providers to install Electronic Data Interchange (EDI) transmission programs in their billing and medical record systems and has altered the methods of communication for all health care professionals.
Global Rationale:

Cognitive Level: Evaluating
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Communication and Documentation
Learning Outcome:

[Charlie]

Thank you

[Perkypinki]

No problemo