Medical billing is a payment practice within the United States health system. The process involves a healthcare provider submitting, following up on, and appealing claims with health insurance companies in order to receive payment for services rendered; such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government sponsored programs: Medical coding reports what the diagnosis and treatment were, and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam, CPB Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field. Some community colleges in the United States offer certificates, or even associate degrees, in the field. Those seeking advancement may be cross-trained in medical coding or transcription or auditing, and may earn a bachelor's or graduate degree in medical information science and technology.
An electronic health record (EHR) is the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.
Medical practice management software (PMS) is a category of healthcare software that deals with the day-to-day operations of a medical practice including veterinarians. Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payors, perform billing tasks, and generate reports.
OSCAR McMaster is a web-based electronic medical record (EMR) system initially developed for academic primary care clinics. It has grown into a comprehensive EMR and billing system used by many doctor's offices and private medical clinics in Canada and other parts of the world. The name is derived from where it was created and an acronym; OSCAR stands for Open Source Clinical Application and Resource and McMaster refers to McMaster University, where it was developed. It enables the delivery of evidence resources at the point of care.
Canada Health Infoway is an independent, federally funded, not-for-profit organization tasked with accelerating the adoption of digital health solutions, such as electronic health records, across Canada. Infoway is focused on two strategic goals:
The Canadian Institute for Health Information (CIHI) is a government-controlled not-for-profit Crown corporation that provides essential information on Canada's health systems and the health of Canadians. CIHI provides comparable and actionable data and information that are used to accelerate improvements in health care, health system performance and population health across Canada.
Patient portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals. Typically, portal services are available on the Internet at all hours of the day and night. Some patient portal applications exist as stand-alone web sites and sell their services to healthcare providers. Other portal applications are integrated into the existing web site of a healthcare provider. Still others are modules added onto an existing electronic medical record (EMR) system. What all of these services share is the ability of patients to interact with their medical information via the Internet. Currently, the lines between an EMR, a personal health record, and a patient portal are blurring. For example, Intuit Health and Microsoft HealthVault describe themselves as personal health records (PHRs), but they can interface with EMRs and communicate through the Continuity of Care Record standard, displaying patient data on the Internet so it can be viewed through a patient portal.
ClearHealth is an open-source practice management (PM) and electronic medical records (EMR/EHR/PHR) system available under the GNU General Public License.
The Zambia Electronic Perinatal Record System (ZEPRS) is an Electronic Medical Record (EMR) system used by public obstetric clinics and a hospital in Lusaka, Zambia.
Electronic prescribing is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.
Practice Fusion is a web-based electronic health record (EHR) company based in San Francisco, CA. The company was founded in 2005 by Ryan Howard and acquired by Allscripts in 2018.
Allscripts Healthcare Solutions, Inc. is a publicly traded American company that provides physician practices, hospitals, and other healthcare providers with practice management and electronic health record technology. Allscripts also provides products for patient engagement and care coordination, as well as financial and analytics technology. The company has more than 180,000 physician users and has products in 2,700 hospitals and 13,000 extended care organizations.
Nightingale Informatix Corporation, commonly abbreviated as Nightingale, is a public company headquartered in Markham, Ontario, Canada with offices in Rancho Cordova, California, Cambridge, Ontario, Kansas City, Missouri, Pembroke, Massachusetts, and Wexford, Pennsylvania. Nightingale provides products and services that support physicians, allied healthcare practitioners, hospitals and other healthcare organizations with their clinical and operational requirements. Nightingale provides EHR and Practice Management services, as well as a Patient Portal, Revenue Cycle Management and Medical transcription services to solo physicians, group practices and large clinics across the United States and Canada. The EMR/ EHR by Nightingale is a web-based program and is hosted in a secure ASP environment.
Digital health, which includes digital care programs, is the convergence of digital technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and make medicine more personalized and precise. The discipline involves the use of information and communication technologies to help address the health problems and challenges faced by people under treatment. These technologies include both hardware and software solutions and services, including telemedicine, web-based analysis, email, mobile phones and applications, text messages, wearable devices, and clinic or remote monitoring sensors. Generally, digital health is concerned about the development of interconnected health systems to improve the use of computational technologies, smart devices, computational analysis techniques, and communication media to aid healthcare professionals and their clients manage illnesses and health risks, as well as promote health and wellbeing.
The move to electronic medical records (EMRs) is becoming increasingly prevalent in health care delivery systems in the United States.
Kareo is an Irvine, California company that provides software as a service for independent medical practices. The company offers cloud computing products and services for electronic health record (EHR) management, medical practice management software, managed billing services and software to help practices engage with their patients. In 2019, the company reported over 55,000 providers using its technology.
Greenway Health, LLC is a privately-owned vendor of health information technology (HIT) including integrated electronic health record (EHR), practice management, and revenue cycle management solutions. Intergy, Greenway Health’s cloud-based EHR and practice management solution, serves ambulatory healthcare practices. The company has offices in Tampa, Florida; Alachua, Florida; and Carrollton, Georgia. Greenway Health was formed in 2013 following Vista Equity Partners' acquisition and combination of three HIT vendors: Vitera Healthcare Solutions, SuccessEHS, and Greenway Medical Technologies.
Home health care software sometimes referred to as home care software or home health software falls under the broad category of health care information technology (HIT). HIT is “the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making” Home health software is designed specifically for companies employing home health providers, as well as government entities who track payments to home health care providers.
QHR Technologies Inc. (QHR) is a Canadian healthcare technology company, founded in 2000. It represents 20 percent of the country's medical record market and its Medeo and AccuroEMR products are used by about 16,400 health professionals.
Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.
