Clinical Source of Truth with Patient Status Orders Automation and Validation throughout the Clinically Driven Revenue Cycle Management Life Cycle

摘要

Methods, computer systems, and computer storage media are provided for facilitating claims management using planned orders. More particularly, encounter information can be synchronized with clinical system data in a revenue cycle management system so costly editing and delays can be avoided. Initially, an order for the patient during an encounter is received from a clinical system. A clinician may be prompted indicating the order cannot be completed because of a conflict. The revenue cycle management system monitors the clinical system for the missing information corresponding to the conflict. Once the missing information is received, the encounter information is synchronized with the missing information. The synchronized encounter information comprises automated edits that enable a claim corresponding to the encounter to be billable.