I need help with this case study, must help would be appriciated! Capstone Case:
ID: 371336 • Letter: I
Question
I need help with this case study, must help would be appriciated!
Capstone Case: New Century Wellness Group New Century Wellness Group offers a holistic approach to healthcare with an emphasis on pre- ventive medicine as well as traditional medical care. In your role as an IT consultant, you will help New Century develop a new information system Background You began the systems analysis phase by conducting interviews, reviewing existing reports, and observing office operations. (Your instructor may provide you with a sample set of interview summaries.) The New Century medical team performs services and medical procedures, which are coded ac- cording to the American Medical Association's Current Procedure Terminology (CPT). CPT codes consist of five numeric digits and a two-digit suffix, and most insurance payers require the codes to be included with billing information. The new system must be able to handle the new ICD-10 procedure coding system, which will be required by the Centers for Medicare & Medicaid Services (CMS) beginning October 1,2014. ICD-10 codes consist of seven alphanumeric characters, which can be electronically transmitted and received. New Century's information system must interface with 25 California health insurance providers. The new system represents an opportunity for significant cost saving for New Century, and more conve- nience for patients, who will be able to go online to update medical information, schedule appoint ments, and request medical records. During your fact-finding, you learned that the clinic requires various reports, as follows Daily appointment list for each provider. The list shows all scheduled appointment times, patient names, and services to be performed, including the procedure code and description. Daily report call list, which shows the patients who are to be reminded of their next day's appointments. The call list includes the patient name, telephone number, appointment time, and provider name Weekly provider report that lists each of the providers and the weekly charges generated, plus a month-to-date (MTD) and a year-to-date (YTD) summary as well as profit distribu . on data for the partners. Monthly patient statement, which includes the statement date, head of household name and address, previous month's balance, total household charges MTD, total payments MTD, and the current balance. The bottom section of the statement shows activity for the month in date order. For each service performed, a line shows the patient's name, the ser- vice date, the procedure code and description, and the charge. The statement also shows the date and amount of all payments and insurance claims. When an insurance payment isExplanation / Answer
Hi...Team,
2..identify six business processes that New Century performs, and explain who has the primary responsibility for each process. Also describe what data is required and what information is required for each process.
HR/Employee Benefits : Fred Brown handles employee benefits. The data he needs for this is all the employee information including
what benefits they are enrolled in. From that he can generate information pertaining to how many vacation days a person has
used/has left, how many personal days, and how many sick days. This would also involve insurance benefits. The information
generated by insurance benefits would help determine payroll information. Finance/Payroll
: Corrine Summers is in charge of payroll. The data she needs for this also includes employee information including direct
deposit information and tax information for generating W-2’s every year. She will also require information from punch cards
(either digital or physical) to determine how many hours an employee has worked and information regarding the employee’s salary
or hourly rate. She will use Fred’s data on vacation, personal, and sick days to help in her calculations.
She will also use the information about their2nsurance benefits to determine the amount of pay to be withdrawn for these benefits.
There are several applications available to aid in the handling of payroll for a company. Patient Records : Susan Gifford is
responsible for the maintenance of patient medical records. She will need a system that records all of a patient’s data.
The information produced by her position is crucial to properly caring for the patients.
She will also make sure that each service issued at the visit is properly coded for billing purposes.
She also is responsible for double checking to make sure insurance data is correct.
Accounts Receivable : Tom Capaletti handles accounts receivable. He will require properly coded reports on patient visits
(which will come from Susan’s data) to determine the total amount a patient owes. The information he generates will be ready
to send to the insurance companies of the patients. Once the bills are submitted to insurance,
he will receive the total the patient owes and mail out the bill surance Billing Specialist :
Tammy Alipio is responsible for billing insurance companies. She will take the information generated by Tom and submit
it to the insurance company of the patient. When she receives the data back from the insurance, she will re-submit the bill
to Tom to send to the patient. Logistics : Carla Herrera is responsible for ordering and organizing office and medical supplies.
The logistics for medical office includes ensuring all medical supplies and medicines are kept stocked and readily available.
This also includes the ordering, inventory and tracking of office supplies required by the staff.
A good database could be used to help with the logistic process to track cost and inventory
3.3. Based on what you know at this point, it is likely that you will recommend a transaction processing system,
a business support system, or a user productivity system? What about ERP system? Explain your reasons. It would be possible to
manage this office entirely with a user productivity system. A well constructed series of databases could be created to do track employee
information/benefits, payroll, patient records, accounts receivable, insurance billing, and Logistics and run this office. This would be
able to maintain them if properly configured and maintained for some time. Having said that, if the office was ever to expand and the number
of offices and personnel grows, I would probably recommend a combination of a user productivity system and a transaction processing
system would probably be best for them. The transaction processing system would help the monetary side the company in managing the accounts receivable and insurance claims. The user productivity system would help with scheduling, logistics, patient records.
4. Describe the systems development method you plan to use, and explain the pros and cons of using this method.
I would use the agile/adaptive methods largely because of the team size I believe it would reduce some of the risk and cost to implement.
Since agile stresses team interaction, having a small team sghould allow for better communication. Additionally because of the
flexibility it would be easier on the staff to implement the new features a little bit at a time so they wouldn’t have to learn an
entirely new system
thanks