Interview of Medical Information Professional Essay Example

Interview of Medical Information Professional Essay Example Interview of Medical Information Professional Paper Interview of Medical Information Professional Paper The debates in the arena of health care provision always center on the quality, availability and the sustainability of the medical provision system. There are a myriad of challenges facing both the receivers and the providers of health care In the center of all these is the state and federal government regulatory framework. To analyze these legal regulatory frameworks and th0eir correlation to health information practice it is prudent to analyze the views from health information professional. This is a comprehensive interview report carried out with a health information professional regarding the legal issues and regulatory challenges they face. The preceding report is presented in question-answer format for easy comprehension and reference. Interview of Medical Information Professional Question: To promote electronic data interchange in the health care system, a number of measure have been put into place including the HIPAA Act of 1996. what are the major contents of this act? Answer: The Health Insurance and Accountability act enacted by Congress protects workers and their families health insurance coverage in case they lose or change their jobs. Through the Administrative Simplification, usually known as AS provisions, it stipulated that national standards for electronic data interchange be established to offer a regulation in this sector. These provisions also address the privacy and security of such data. Title I of the act has specific articles that regulate health care access, the portability of health care provision and renewability. Title II has policies that ensure the prevention of health care fraud, the AS, and the medical liability reform. Several chapters ensure that there is privacy and security of data, that transactions are carried in accordance with the transactions and code rule. The regulation of the activities of the relevant health care providers are enshrined in the unique identifiers rule and the enforcement rule. All these sought to promote and provide a regulated free and safe electronic data interchange. Question: What major role does Medicare and Medicaid play in dealing with insurance coverage? Answer: The Center for Medicare and Medicaid Services (CMS) is the principal organ controlling the countries health care insurance. Medicaid operates as a joint, voluntary entitlement program between the states and the federal government to offer health insurance coverage to the poor, disabled or the elderly impoverished members of the society. Guidelines are developed by the government prescribe minimum eligibility and coverage standards and requirements. Medicare healthy insurance program offers insurance to those over sixty five years of age. Question: What major role does Medicare and Medicaid play in dealing other   emerging challenges? Answer: CMS has both an administrative and a regulatory role. It administers health care insurance portability standards, administrative simplification standards, quality standards for nursing facilities and clinical laboratory standards. Using powers vested in the institution it therefore ensures that all health care providers work in compliance with laid down codes of conduct in clinical practice. Question: Are there other institutions that assist health care providers to ensure compliance? Answer: There are legal institutions that lead the sophisticated and sometimes very complex business transactions in health care. They also offer litigation in legal challenges for their clients. Additionally they are leaders in health care information systems and technology and health care insurance policies and plans. Because of the complex evolving rules and regulations,   through their billing and reimbursement services they assist medical providers in the development and implementation of legal strategies so that they can achieve Medicare compliance. As a health information professional these institutions form the yard stick of our operations because compliance to the stringent legal framework is the only way that an ethical practice can be achieved. Question: There is a growing concern of professional malpractice and negligence. Are these litigious claims substantive? Answer: There are cases where court cases have been won as regards professional misconduct or negligence by health information professionals. Such cases are individual isolated cases even though due to publicity and the sensitivity of such cases they have continued to draw unfathomable public furor. These cases are important starting points of carrying out full intellectual discourse and policy debates. However, malpractice litigation is a negligible variable in health care reform. There is infrequent compensation of victims of medical negligence while providers are rarely held accountable.