-
digital.ahrq.gov/sites/default/files/docs/page/09-0071-EF_1.pdf
June 01, 2009 - .18
§ Errors and Omissions insurance (E&O) and Cyberliability: protects the organization from
claims … the indemnifying partner has acquired enough liability coverage to pay for any
potential damages or claims … In the case of the MSeHA,
some of the public hospitals in Tennessee fall under the Tennessee Claims … A recent study, however, found that
physicians with EHRs appear less likely to pay malpractice claims … Electronic health records and malpractice claims in office practice.
-
digital.ahrq.gov/sites/default/files/docs/publication/uc1hs015431-brooks-final-report-2007.pdf
January 01, 2007 - Phase I Analysis: The effectiveness of IT implementation was assessed
through a pre-post analysis of 6 claims-based … should also include first the evaluation of the reliability of data
that comes from small facilities claims … measurement of data quality was created (Data Quality Measure) for
each hospital, based on the percentage of claims … by total claims
-
digital.ahrq.gov/sites/default/files/docs/publication/r18hs017795-eisenstein-final-report-2012.pdf
January 01, 2012 - The system was based on
HL7 standards for decision support and utilized routinely available claims and … The
imported data include encounter and pharmacy claims data from the State Medicaid Office, as
well … obtained via ADT feeds from network
hospitals, practice management data from network clinics, and claims … Rate of ED encounters
Rate of hospitalizations
Rate of outpatient encounters
NC Medicaid claims … fees
Pharmaceutical reimbursement
ED costs, hospitalization and outpatient
costs
NC Medicaid claims
-
digital.ahrq.gov/sites/default/files/docs/activity/e_prescribing_impact_2009_update_2.pdf
January 01, 2009 - To accomplish this aim, all pharmacy and medical claims from 2003 through the first quarter of 2005
-
digital.ahrq.gov/sites/default/files/docs/E-Prescribing%20and%20Medication%20Management%20(1).pdf
March 31, 2009 - Patient
1 2 5
Provides Patient:
Eligibility
Benefit & Formulary
Medication Claims
History … history for patients they are
treating in an inpatient setting
–
Person search
–
Dispensed claims
-
digital.ahrq.gov/sites/default/files/docs/page/IAVR_ExecSumm_1.pdf
December 29, 2006 - giving patients a cause of action for inappropriate disclosure, and another
reported that HIPAA-based claims … are being included in lawsuits by patients frequently
enough that one provider had reported 6 such claims … (The
specific legal basis for such claims was not identified.
-
digital.ahrq.gov/sites/default/files/docs/implementation/Wheeler%202-I.ppt
June 05, 2006 - Slide 1
The Michigan Upper Peninsula Critical Access Hospital HIT
Network Implementation Project
Donald A. Wheeler, FACHE
Primary Investigator
Moving Community Health To the 21st Century
AHRQ 2006 Annual Patient Safety & Health Information Technology Conference
June 5, 2006
Critical Access Hospital HIT
Netw…
-
digital.ahrq.gov/sites/default/files/docs/20081027_Transcript_CD_WS.pdf
October 27, 2008 - Couple
of concerns, there is a school of thought which claims that they're sort of worried that young … We are also aware that there is a lot of
data that's available in clinical settings, claims data. … This system receives and displays external billing,
claims and clinical data from five hospitals, eight … individual-- care transition
that transpired and some relative information that we can obtain from the claims … This just highlights that this is all derived from claims data
Use of Clinical Decision Support and
-
digital.ahrq.gov/ahrq-funded-projects/reducing-hospital-readmission-rates-implementing-inpatient-tobacco-cessation
January 01, 2023 - and healthcare costs for patients, increase efficiency in patient care for the hospital, and decrease claims
-
digital.ahrq.gov/sites/default/files/docs/page/e-prescribing-toolset-pharmacy.pdf
January 01, 2020 - One e-prescribing
intermediary network claims participation from 98 percent of chain pharmacies, vs. … pharmacy management software
system depending on how your software handles this field for submitting claims … Errors in days supply may lead to issues with claims
submission and reimbursement—the following case … In addition to handling the
basic standards for prescriptions and prescription claims, Medicare Part
-
digital.ahrq.gov/sites/default/files/docs/page/4-GLIDES-LegalAspects.pdf
March 02, 2011 - (1990-99)
– 20 common procedures
– Anesthesia, ED, OB-GYN, radiology
– Goal: resolve malpractice claims
-
digital.ahrq.gov/sites/default/files/docs/page/e_rx_evaluation_guide.pdf
February 01, 2010 - Decreased costs for
program
administration of
individual claims.
Costs: None. … Impact of CDSS
on all pharmacy
claims and per
member per
month
expenditures. … Examined new
prescriptions
and their refills
via database
queries on
pharmacy
claims. … Method/type of
analysis
Identified all new
prescription claims
for the two groups
of clinicians … Retrospective
review of
pharmacy claims
data from 2 groups
of doctors: 95
using e-prescribing
and
-
digital.ahrq.gov/sites/default/files/docs/20070315%20Model%20Contract%20Language%20for%20Health%20Information%20Exchange.pdf
March 15, 2007 - A request from a claims processor allows a limited and different set of information to pass through. … They did not insist upon being indemnified by third-party claims, and so they still are responsible to
-
digital.ahrq.gov/sites/default/files/docs/clinical-care-slides-10142020.pdf
October 14, 2020 - with Diabetes
• Problem: lifestyle counseling not recorded in any
structured data (e.g., billing claims
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs025000-liss-final-report-2019.pdf
January 01, 2019 - Hospital encounters during follow-up
were identified using retrospective Medicaid plan claims. … however, five lost Medicaid plan coverage during follow-up and were excluded due to
lack of available claims … During follow-up, 17 (29.8%) participants had any claims-validated hospital encounters; three
participants
-
digital.ahrq.gov/sites/default/files/docs/page/health_it_and_hie_initiative_governance__establishing_the_medicaid_presence_within_the_state_hie_governance_structure_5.pdf
February 25, 2010 - infrastructure
• Business and technical ops
• Legal and policy
Types of Exchange
• Eligibility and claims … Stakeholders and Ongoing Related Collaborative Efforts
Health Planning
Advisory Committee
All Payer Claims … environment
• Preparing an RFP for EOHHS-wide
Common Client Index tool
• Participating in all payer claims … Medicaid consortium
• Potential regional efforts include master patient/provider indices, all payer claims … and customer service functions as well as
provider enrollment, credentialing, customer service, and claims
-
digital.ahrq.gov/sites/default/files/docs/page/identity_management_for_interoperable_health_information_exchanges_5.pdf
March 26, 2008 - Requirements:
Entities are authenticated to assure that the entity is
the person or application that claims
-
digital.ahrq.gov/sites/default/files/docs/page/length-of-stay-quick-reference-guide.pdf
March 01, 2009 - Measure: Medical Records
(Discharge Summaries, Daily Notes); Computerized
Information Warehouse; Claims
-
digital.ahrq.gov/sites/default/files/docs/hie-slides-011713.pdf
January 17, 2013 - Original Research Design
• Measure HIE impact on patient outcomes (readmissions, ED use) using claims … Data Sources: patient outcomes
Challenge: Claims unavailable
Solution: Rely on HIE data
• New Challenge
-
digital.ahrq.gov/sites/default/files/docs/citation/state-regional-demonstration-hit-in-evaluation-report.pdf
July 01, 2015 - In order to
support the QHF program we added two additional sources of data to the INPC: claims data … Claims data were obtained
from payors and converted into HL7 messages containing the relevant data including … Second, the
claims data proved very useful to providers for clinical care. … In order to support the QHF program we added two additional sources of data to the INPC: claims data … Second, the claims data proved very useful to providers for clinical care.