Re: [Gnumed-devel] Introducing myself and questions on billing/accounting

[Sebastian Hilbert]

Am Donnerstag, 19. Mai 2011, 09:05:37 schrieben Sie:
> On Wed, May 18, 2011 at 11:27 PM, Sebastian Hilbert
>
> > 1) That leads to the question if GNUmed passes on billable items and LSMB
> > processes them by reviewing them and creating an (e.g.) printed invoice
> > what happens if at the LSMB level somone decides to kick a few billable
> > items.
> > 
> > It is of any concern to the EMR / doctor ? Would the doctor be interested
> > to know that a billable item was not billed ?
> 
> First, human review is critical in any sort of automation like this.
> You absolutely want to know that the data is reviewed and signed off
> on.  In this set up you have a clear paper trail and data is saved on
> every step.  If there is an issue you can track what went wrong.  Was
> it an import issue?  Was it someone who messed with things before
> posting the invoice?  Was it the doctor who entered the wrong info?
>

Understood
 
> When you start updating upstream, you add some significant problems to
> this ability to track the paper trail.  I would recommend against it
> for that reason primarily.
> 

+1

> > 2) On a completely different matter (on of interest later on and might
> > not pertain to LSMB at all): Here in Germany there exist a set of rules
> > which billable items can be combined and which cannot.
> 
> Not sure I understand.  But if it has to do with what can be on the
> same invoice, that sounds like a mess.
> 

Here is the deal. Patient calls in and you talk to him. you can bill that. 
then patient comes in and you talk to them, then you do a physical 
examinnation. In this case you can only bill the physical since you talked to 
him before (on the phone). Had the patient not called befor you could have 
billed the talk before the physical examination.

Enough mess ? :-)

It involves three different billable items but only two can be billed for 
combination reasons.

However this step (rules engine) could be implement above the gateway to LSMB 
so data send to LSMB has been processed by the rules engine before.

In the end this has nothing to do with the initial implementation. Just wanted 
to raise it in case it changes things conceptually.

> > 
> > Is there such a multiplied concept in LSMB ? In a first working (and
> > highly usable) implementation we can assume the multiplier to be one
> > (1). We could also have LSMB host multiple billiable items (which imply
> > the factor) or LSMB could have the concept of the multiplier (but maybe
> > this does not make much sense since this is Specific for Germany).
> 
> LSMB has a discount field which could be hijacked to act as a
> multiplier....  If you have per-line discounts too, then that could
> require a little more work....

We have per line discounts :-) You though it was that easy ?

each billable item can have a discount ( or negative discount in that case)

Best regards,
Sebastian