Author Question: Electronic data interchange (EDI) has been instrumental in facilitating the health care process. ... (Read 39 times)

charchew · **on:** Jul 7, 2018

Electronic data interchange (EDI) has been instrumental in facilitating the health care process. Which of the following responses best describes the impact of the EDI?

1. EDI has the potential to eliminate second opinions.
2. EDI interacts with multiple databases.
3. EDI supplies proof of recovery.
4. EDI facilitates the approval of patient claims.

Question 2

Mrs. Owens has come to the clinic to see the nurse practitioner about her persistent cough. Recently, she was laid off from her job at the retail store and lost all benefits. She has had a fever and chills for several days.

As the nurse begins the assessment, Mrs. Owens begins to cry and says: I have no money to pay for medicine or this visit. Please do not order an antibiotic, because I cannot pay for it. The nurse's best response would be which of the following? 1. I understand your concerns, Mrs. Owens. I have free medicine from donors to give you.
2. I understand your concerns Mrs. Owens. It looks like you will qualify for Medicaid benefits.
3. Don't worry Mrs. Owens, I won't prescribe an antibiotic.
4. Mrs. Owens, perhaps you can be seen in the emergency department. They can give you free antibiotics.

vish98 · **Reply #1 on:** Jul 7, 2018

Answer to Question 1

4
Rationale: The welfare of the person being treated depends on the accurate transference of information from one health care professional to another, and reimbursement is more and more dependent upon electronic data interchange or EDI. Great strides have been made in the technology which allows medical necessity proofs to be piggy-backed with claims, avoiding the need for holding up the processing of such claims.

Answer to Question 2

2
Rationale: Medicaid eligibility is income based. Recipients must meet criteria based on their medical needs, income and other resources, or lack thereof, to pay for those needs. Eligibility is regulated by each state based on criteria determined by each state. In some states, recipients pay co-payments on a sliding scale for some services.