Re: [Gnumed-devel] Introducing myself and questions on billing/accounting

[Sebastian Hilbert]

Am Donnerstag, 19. Mai 2011, 01:25:52 schrieb Chris Travers:

Hi,

> 
> 1)  Doctor enters EMR info, including billing stuff
> 2)  Bills get input into accounting system
> 3)  Bills get reviewed by billing department and posted to the books
> as receivable.
> 4)  Bills get submitted (either to private pay individuals or to
> insurers whether public or private).
> 
> This human review is absolutely critical in every business I have ever
> looked at.  It reduces data entry errors, provides some level of
> sanity checks, and avoids a lot of problems.  Then the data can be
> pulled and sent to the billing gateway through a third party engine.
> 

Most software products (at least in Germany) that call themselves EMR (and are 
barely more then a billing software) do ship the billing and processing 
functionality in one program instead of making use of interfaces.

1) That leads to the question if GNUmed passes on billable items and LSMB 
processes them by reviewing them and creating an (e.g.) printed invoice what 
happens if at the LSMB level somone decides to kick a few billable items.

It is of any concern to the EMR / doctor ? Would the doctor be interested to 
know that a billable item was not billed ?

2) On a completely different matter (on of interest later on and might not 
pertain to LSMB at all): Here in Germany there exist a set of rules which 
billable items can be combined and which cannot. 

To give you and idea of what is involved to bill private insurers here is an 
example of an invoice

http://www.derprivatpatient.de/fileadmin/alte_uploads/pdf/musterrechnung_01.pdf

here is the layout:

encounter date | billable item identifier  | billable item description | how 
many of those to bill | factor | cost


The factor column here is interesting. For each item you can not just specify 
how many of those you want to bill but also a multiplier which supposedly 
increases the value of that item (because it took you more work then usual to 
do it).

Is there such a multiplied concept in LSMB ? In a first working (and highly 
usable) implementation we can assume the multiplier to be one (1). We could 
also have LSMB host multiple billiable items (which imply the factor) or LSMB 
could have the concept of the multiplier (but maybe this does not make much 
sense since this is Specific for Germany).

As for the rules we will get to that later (since 2 does not concern the 
initial implentation)       

Regards
Sebastian