Health Informatics Fundamentals
Click on the subdomain titles to examine the range of skills and concepts a student can expect to demonstrate for assessment of this Domain:
- Coding and Reimbursement Methodologies
- Healthcare Ecosystems
- Legal and Ethical Considerations in Healthcare
Coding and Reimbursement Methodologies
- The graduate selects a clinical classification for billing coding and reimbursement that meets applicable regulatory requirements.
- The graduate constructs a Joint Commission plan of action for recordkeeping compliance.
- The graduate develops policies and procedures for a healthcare organization consistent with Medicare rules and regulations for billing, coding, and reimbursement, and consistent with Joint Commission and Health Insurance Portability and Accountability Act (HIPAA) requirements.
- The graduate analyzes current healthcare industry issues such as the role of public and private stakeholders, inappropriate application of terminology, information standards and technology, privacy and security requirements, insurance and reimbursement mechanisms, licensure, accreditation, and regulatory compliance.
- The graduate develops a model for delivery of services under a specified government healthcare program.
- The graduate develops a detailed model for a new program or system for a federal, state, or regional healthcare agency, addressing regulatory requirements, industry-specific standards, accreditation requirements, and technical and business requirements.
- The graduate formulates a slate of requirements and processes for a given private healthcare organization to meet the criteria of a specified certification or accreditation program.
Legal and Ethical Considerations in Healthcare
- The graduate develops and implements privacy and confidentiality policies and procedures for a healthcare organization.
- The graduate constructs a patient education training program for a specific terminal disease, integrating autonomy, accountability, and confidentiality.
- The graduate develops a framework for a new physician entering private practice that describes the physician's ethical and legal duties to the public, patients, and associated medical institution.