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


From: Jim Busser
Subject: Re: [Gnumed-devel] Introducing myself and questions on billing/accounting
Date: Fri, 20 May 2011 08:16:21 -0700

On 2011-05-20, at 3:06 AM, Karsten Hilbert wrote:

> A billable item would be a template of sorts for a billed
> item.

When we are modelling tables

        bill.billable_item
        bill.billable_encounter_types

- is the prepended "bill" in each case a database, and
- must any one database be "owned" (with its permissions a property of) only 
one schema

… in which case would the discussion to date propose / require distinct 
databases thus

        bill.billable_item              <--- in LSMB

        bill.billable_encounter_types           <--- in GNUMed

        (which might be confusing therefore better-named differently)

*************************

Second, on the proposal for GNUmed to keep a copy of some reference data 
grabbed from LSMB "billable items", what is the extent of duplicating the data 
structure an data itself? For example, let us say that in LSMB there is more 
than

        billable item description (Consultation)
        billable item code (00010)

say

        billable item shortname (Cons)

and even more… rules that concern limits, or discounts, or additional needed 
data

        max in year (6)

        discount if this is a 2nd/3rd… service at same visit (50%)

        billable item needs diagnostic code {CA:ICD9, BR:ICD10,DK:SNOMED) <--- 
guessing… I don't really know

        if diagnostic code or procedure code pertains to a limb, need "R" for 
right or "L" for left if english, else other letters

how much of this is supposed to get synced into a clonal GNUmed table, vs how 
much we are going to *ignore* in the EMR and rely on the praxis to train the 
doctor or the doctor to train themself to know their own local and 
insurer-based billing requirements?

I am thinking that in the EMR, the billed_item might better contain *only* 
minimal data of the sort LSMB may require with the further addition of only

        - a few fields for sane administration (link to encounter; status; date 
uploaded)
        - possibly a comment_formatted field

The idea of  comment_formatted being future-use so that whoever would write 
smarter / customized plugins could "wizard" into this field and then allow the 
user to complete whatever additional content will be required by the paying 
agency, including support for the data specification.

-- Jim


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