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Components
PreEncounter Encounter Future Development
| Term | Definition |
|---|---|
| Pre-Encounter | Customer Service and Referral Services- Phys 2 Referral Center to Phys - Patient to Referral Center to Phys- Managed Care to Specialist |
| Pre-Encounter | Patient Assessment- Clinical and financial, include discussion about alternate options- review will result in the development of a plan |
| Pre-Encounter | Resource Scheduling- receipt of a request to arrange a place, equipment and/or person(s) for a defined date and time. |
| Pre-Encounter | Pre-Registration- The collection, dissemination and storage of registration information, including demographic, financial, and clinical data, prior to the patient’s arrival. |
| Pre-Encounter | Patient andFamily Education- program is planned utilizing the results of thepatient assessment. The plan includes: a determination of available materials and appropriate teaching tools and methods, the timing of the teaching and the audience |
| Pre-Encounter | Clinical Prerequisites- determination of required clinical prerequisites for planned healthcare service is obtained from physician orders and other established protocols. Clinical prerequisites include, but are not limited to, preps and testing. |
| Pre-Encounter | Financial- Prerequisites, Assuring that all the appropriate payors have been identified, their requirements have been met, and there has been communication with the patient about their financial obligations prior to service. |
| Pre-Encounter | Payor Authorization- Approval from third party payors to provide specified care in a particular setting; written or electronic assurance that the services provided will be covered under the terms of the patient’s healthcare plan. |
| Pre-Encounter | Verification of Benefits-process of confirming benefits for services. Process of verification of demographic, financial and ins information that is obtained either through pre-reg or sched is second in importance only to the process of pre-cert. |
| Pre-Encounter | Pre-encounterCommunications -Oral or written info shared with patients, their families, and care providers prior to arrival for service. Includes answering questions, providing information on preparations for tests and treatments, directions, sched. |
| Future Development | Statistical Reporting-Statistical reporting provides timely summarized information for process improvement, administration and management, surveys and audits, Joint Commission, requests from the legal department, etc. |
| Future Development | Resource Mgmt -Managing resources 2accommodate physician/pt needs w/across depart. or HCP settings. Includes responding to statistical monitors thru scheduling system to adjust for patterns of delay and responding to individual phys or pt resource needs. |
| Future Development | Customer Satisfaction-Ability to provide undisputed professional courtesy, respect and confidentiality while collecting complete and accurate info-objective measurement of the level of satisfaction as expressed by customers |
| Future Development | Staff Education and Competency-Quality performance is an essential component in maintaining a patient flow that is efficient and timely and promotes high level of customer satisfaction. |
| Future Development | Physician Relations- Coordination with physicians in the provision of care. Services provided to minimize the process steps necessary for physicians to achieve access for their patients. |
| Future Development | Productivity and Accuracy- The ability to professionally manage the volume of patient registrations while maintaining the desired level of data collection quality. |
| Future Development | Benchmarking-Formal comparison of the quality of service, productivity, customer satisfaction and/or costs with similar functional groups to improve process or performance. |
| Encounter | Billing-The process of collecting and presenting to the payor all agreed upon data elements that are necessary to secure payment for services rendered. Includes initial billing, follow-up, cash posting, and management of accounts receivable. |
| Encounter | Census Management-Accurate accounting of patient activity within or across entities and accurate use of data interfaced to fiscal or other statistical systems. |
| Encounter | Charge Capture- electronic or manual applying predetermined fees associated with service delivery. Order/charge entry, verification charge correction. process must assure charges accurately to correct account so process flows effectively 2 billing. |
| Encounter | Departure-Preparation and actual departure of patient from an encounter. Though departure planning occurs throughout the continuum of care,a smooth departure would include appropriate communication of the plan, responding to all questions, coord of f-up |
| Encounter | Patient Management System Transactions-Admission/Discharge/Transfer transactions (ADT) reflect the heart of traditional admission and bed control functions. ADT transactions record these routine patient activities on-line. |
| Encounter | Order Entry- Entering orders for clinical services into the healthcare information system(s). Frequently involves some interpretation |
| Encounter | Patient Placement The process of providing the most appropriate location and level of service necessary for optimum clinical care delivery to the patient. In many hospitals this process is referred to as bed control/management. |
| Encounter | Patient Check-in, Admission, Registration- This can occur at any point of access in a centralized. processes related activation of an encounter/account a review of demographic, guarantor, and insurance information; copying cards; obtaining consents |
| Encounter | Patient Tracking -Documentation of arrival and departure to allow caregivers to know where a patient is at any point of service during an encounter. |
| Encounter | Concierge Services- The term concierge, historically applied to the “doorkeeper,” comes to healthcare from the hotel industry. The concept has been expanded to indicate an individual or service geared to the needs of the customer and their satisfaction. |
| Encounter | Transport/Routing Coordination-Some access departments are responsible for a formally organized department of transportation, which move patients and mail through out the enterprise. |
| Encounter | Wayfinding-In simple medical facilities, wayfinding may refer to a signage system that directs patients, family, and visitors to their destinations. |
| Encounter | Information-Providing information by answering direct questions as well as anticipating customers’ questions. |
| Encounter | Family Liaison Services-All services that address the needs of patient’s families or visitors within and across healthcare settings. This includes coordinated |
Created by:
Copa
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