Iimbopheleleko zoLawulo loLwazi lwezeMpilo

Ukuqinisekisa ukuchaneka, ukufikeleleka, kunye noBucala boLwazi lwezeMpilo

Ulawulo loLwazi lwezeMpilo yinkqubo yokugcina, ukugcina nokufumana ulwazi lwezempilo lwesigulane ngokuhambelana neemfuno ze-Federal, State, kunye neemfuno zeejensi zokuvuma. Kukho iimbopheleleko ezili-10 eziphambili kwisikhokelo solawulo lweenkcukacha zempilo (HIM) ezifuna ulwazi olukhethekileyo, izakhono kunye namakhono. Nantsi isishwankathelo esifutshane kwezi zixanduva ezilishumi.

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I-Basics yeCoding Coding

Ukubhalwa kweenkcukacha zezokwelapha kubandakanya isabelo esifanelekileyo sekhowudi yezobugqirha ekubuyiselweni ngokufanelekileyo ngabaxhasi kunye nabathengi abanjengoMagare kunye neMedicaid. Kwakhona kuthetha ukuqinisekisa ukuba zonke iirekhodi zempilo zibandakanya ukuxilongwa okufanelekileyo ngokulandelelana kwenkqubo. Kukho iiseti eziliqela zeekhowudi ezisetyenzisiweyo, kwaye kufuneka zibe nezixhobo ezisesikhathini esiphezulu njengoko ezinye iikhowudi zitshintsha rhoqo ngonyaka.

• Iikhowudi ze-ICD-9
• Iikhowudi ze-CPT
• Iikhowudi zeHCPCS
• DRG (Ukuxilongwa kwamaqela ahlobene)
• Abaguquleli

Kaninzi

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Ngonyango

Utshintsho lwezokwelapha lubhekisela kwi-transcription echanileyo kunye nexesha elifanelekileyo lenkcazelo yempilo yesigulane yokunyamezela ukuba ifikeleleke kumaqela agunyazisiweyo:

• Imbali yonyango
• Imibiko yesifo esineemonde
• Iingxelo zokubonisana nodokotela
• Isishwankathelo sokukhutshwa komonde
• Ingxelo ze Radiology
• Iingxelo zomsebenzi

Kaninzi

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Uncedo lwezoNyango

Iimfuno zonyango zibhekiselele kunyango olufanelekileyo kunye oluyimfuneko, iinkqubo okanye iinkonzo zesifo. Uninzi lwabatshutshisi, kuquka i-Medicare ne-Medicaid, abayi kuhlawula unyango olungacatshangwanga oluyimfuneko ngokuxhomekeka kwimigangatho yononophelo.

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Uncedo lwabasebenzi bezonyango

Inxalenye enkulu yokulawulwa kolwazi lwezempilo inikezela ulwazi kumayeza malunga nezigulane eziphathwe ngabo njengoko ziceliwe. Kwakhona kubandakanya ukuphonononga iirekhodi zokuthotyelwa kwikhokelo yomshuwalense karhulumente, i-federal kunye neyodwa. Emva kokuphononongwa, naluphi na ubuthathaka bokuthotyelwa kufuneka kuhanjiswe kumagqirha kunye nezinye iiklinikhi ukuba zivumele ukuba ziphucule amaxwebhu abo.

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INdibano yeeNgxelo zezoLo

Ingxelo nganye yonyango kufuneka ihlanganiselwe ukusetyenziswa ekuqhubekeni ngononophelo lwempilo ngokubonelela:

• Ingxelo echanekileyo, esemthethweni
• Utshintsho lweengxelo zonyango
• Ukungeniswa kolwazi lokubuyisela
• Ukufikelela kwizixhobo ezigunyaziwe ezicela ulwazi

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Ukugcinwa kweeNgxelo zezoNyango

Ukugcina iirekhodi zezogulana zezigulana kubandakanya ukuqinisekisa ukuchaneka nokufikeleleka kweirekhodi zokuqhubeka nokunyamekela ngexesha lokuphila kwesigulane. Ezi ziquka zombini iphepha neirekhodi zonyango.

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U kufakwa

Iifayili zonyango zonyango ziquka ukuyila nokuphuhlisa isakhiwo senkqubo yolawulo lwempilo

• kufumaneke lula
• lu ngi selelwe
• khusela imfihlo yengcinezelo
• ngokuhambelana nemithetho kunye nezikhokelo ze-HIPAA

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Ubumfihlo kunye noKhuseleko

Ngokusetyenziswa kwandisa iteknoloji yolwazi kwiinkonzo zempilo, iofisi yakho yezokwelapha kufuneka iqhubeke nokufumana iindlela zokugcina ubumfihlo kunye nokukhuselwa kolwazi lwezempilo olukhuselekile (PHI) lwezigulane abakhonza ngazo.

• Ukugcinwa kolwazi lwezempilo olukhuselekile ngendlela ekhusela imfihlo yezigulane
• Ukuphunyezwa kweempawu eziqinisekisa ukuba abasebenzi be-ofisi yezobugcisa banokuqeqeshwa okufanelekileyo kunye nokugunyazwa ukufikelela kwi-PHI
• Sebenzisa ukulawulwa kwe-encryption ukukhusela idatha edluliselweyo kwinethiwekhi

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Ukukhutshwa kolwazi

Ulwazi olunomonde luyacelwa ngezizathu ezininzi ezifana nenjongo yomshuwalense okanye ukuqhubeka kokunyamekela. Iofisi yonyango inomthwalo wokukhulula ulwazi ngexesha elifanelekileyo ngexesha lokugunyaziswa okufanelekileyo kwesigulane okanye ummeli ogunyazisiweyo. Ukukhutshwa kweenkonzo zolwazi kubandakanya:

• Ukufumana imvume egunyazisiweyo yokukhutshwa kolwazi lwezempilo olukhuselekile
• Ukugqitywa kwerekhodi yezokwelapha ukukopisha
• Ukuhanjiswa kwerekhodi yezempilo yekhompyutha
• Izicelo zokulandelela kunye nokubeka esweni ukuphendula ngexesha

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Ukugcina Ubumfihlo

Bonke ababoneleli bezempilo banembopheleleko yokugcina abasebenzi babo baqeqeshwe kwaye banolwazi ngokuphathelele imfihlo yesigulane. Ukuxelelwa kwabasebenzi ukukhusela ulwazi olunegulane kufuneka lubandakanye

• Ukulahlwa kakuhle
• Ukugcina okufanelekileyo
• Ukufikelela okufanelekileyo
• Ukudalulwa okufanelekileyo