METHOD AND APPARATUS FOR FACILITATING DELIVERY OF MEDICAL SERVICES

摘要

An electronic system serves as a single point of integration for all electronic health care information systems. A physician selects a diagnosis, which is converted from the physician's preferred terminology to a standard ICD diagnosis. The system then proposes a preferred treatment appropriate to the selected diagnosis (408). The physician can change any items of the proposed treatment plan (406), with changes being checked against payor rule s (408), prior patient information and selected authority guidelines. If a diagnosis/treatment element is not authorized by the payor for the selected diagnosis, the system notifies the physician, allowing changes (412) or offering electronic request for payor authorization. The system may indicate those diagnoses for which payor allows said elements, allowing the physician to choose a diagnosis that is consistent with the patient's symptoms and supports the desired treatment. Upon accepting a diagnostic/treatment plan (420), the plan elements are carried out automatically (422).