HMOs, unlike PPOs, require a great deal of labor to be performed by the provider’s staff. Pre-approvals are a major component of this labor for events such as specialist-based consultations from those that are in-network and out-of-network, letter generation, appointments, and even facility approvals for tests such as those within the radiology domain.
Some of this labor is handled electronically, such as the ANSI X12 270 standard that involves eligibility, coverage, or benefit inquiry. Others such as letter writing and scheduling involve elements from within a Document Management platform or Practice Management Systems (PMS).
To support this Discussion, search the Internet for information on HMOs and PPOs, such as can be found at the Health Insurance Web site
In this Discussion, answer the following questions:
What are the technical challenges of a medical practice that engages in electronic transactions, document management, and scheduling but also uses analog forms?
How are the IT needs for an HMO and a PPO different?
How can the IT needs for an HMO and PPO be integrated, especially if there is not one overarching HIS Application handling it all?
NOTE: it should be in APA format topic, subtopic to all question, In text citation and reference as well.
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.Read more
Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.Read more
Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.Read more
Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.Read more
By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.Read more