HN2: Introduction and Manual

Version R1

CONTENTS

  1. Menus
    1. Programs
    2. Fees
    3. Pharmacy
    4. Reports
    5. System
    6. Appointments
    7. About HN2
  2. Client Lookup and Activation
    1. Entering a New Client
    2. Searching for an Existing Client
    3. Client Activation
  3. Visit Encounters
    1. Actions
    2. Components
    3. Immunization Encounters and Detail
    4. Pregnancy Related Encounters
    5. Contacts
  4. Employee Initials for Use in Experimenting with HN2
  5. Medicaid/Medicare Billing and Data Submission Modules
    1. Medicaid/Medicare Billing
    2. Data Submission

HN2 will work with Netscape 4, Mozilla/Netscape 6, and Internet Explorer . However, it was developed for Mozilla/Netscape and works best with this application. It is best viewed on a 17" or larger screen at a resolution of 1024x768. The browser's print button can be used for printing reports or displayed screens. If you are unfamiliar with internet navigation and data entry click here for instructions.

1. Menus

HN2 uses a standard internet interface. The menu appears just below the browser toolbars and employs a mix of icons and hotlinks. The icons work as follows:

The menus are described below.

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1.1 Programs

These are the clinic service encounter areas such as Adult Health (hypertension/diabetes), Child Health, and Family Planning. Infectious diseases contains HIV, STD, and TB encounters; Miscellaneous services contains Acute Care, Screening/Other Services, and Outreach/Adolescent Services encounters; and Follow-up/Case Mgmt. contains Contacts (phone calls) and Child Tracking (C1st) encounters.

Lab Tests contains a slightly different type of information. Whenever a CLIA lab is entered through an encounter as having been run or sent off, a record is automatically created for it under Lab Tests. The result for that lab test can then be entered through the Lab Tests section.

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1.2 Fees

Fees are generated and billed to the patient whenever an encounter is entered and saved. The Fees menu contains supplementary fee utilities. The Fee Payment option under the fees menu is strictly for entering payments made without an associated visit, such as when a patient comes in specifically to pay off part of an outstanding balance. Payments entered through this screen are not linked to any specific program area or visit. The Adjust Bill or Payment screen is used to correct data entry errors on payments and to make adjustments for events such as a returned check. Bills seldom need to be adjusted through this screen, since correcting the original encounter also corrects the associated fees billed in most cases. Cost per Client's Percent Pay is a fee calculator which will be operational in the near future.

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1.3 Pharmacy

Drugs that are dispensed through the various encounters, along with VFC vaccines that are entered through the immunization encounter as having been given, are automatically subtracted from the pharmacy inventory which is maintained in HN2. The Pharmacy section contains an Adjustments utility that allows other inventory changes, such as shipments received or drugs that have expired, to be recorded.

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1.4 Reports

The Reports menu contains all the reports currently available through HN2. Links to specific report categories can also be found in several of the programmatic areas. A few reports compare information across counties and can only be run at the district level. Also, in this demonstration version of HN2 the hardcoded print options found in a few of the reports are not functional. For these specific reports, please choose the display option and then print the reports from the browser if desired.

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1.5 System

Employee initials and other information such as job functions (NP, RN, clerk, etc.), teams, and login names are maintained through the Employee Information utility. This section is password protected. The Maintenance section is used only by Computer Services.

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1.6 Appointments

The appointment scheduler will be implemented soon.

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1.7 About HN2

Information concerning recent updates to the system is maintained in this section.

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2. Client Look-up and Activation

HN2 Operates on a client-centered principle. In order to enter or look up information in the program areas, a client must first be selected and activated.

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2.1 Entering a New Client

To enter a new client into the system, click on the Add New Client button from the people icon. Enter all the required data and then click on the Save or Add And Update buttons. For a person not having a chart, only the First Name, Last Name, Address (all fields), Birth Date, Race, and Sex fields must be entered. The Maiden Name (for females), Needs Translator, Marital Status, and Education fields must also be entered for any patient having a chart number. An anonymous client may be entered by changing the Anonymous Client box at the top of the client register to yes. Only the Zip, Birth Date, Race, and Sex fields must be entered for an anonymous client.

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2.2 Searching for an Existing Client

If a client is already in the system, they can be located by searching for them through the people icon. Clients can be looked up by last name, first and last name, birth date, Social Security number, Medicaid number, or HIV test code number. A list of possible clients is returned. To see the demographic data for a given client, click on their client id hotlink. (The client id is a unique identifier assigned by the computer to each client. This is different from the chart number, which corresponds to the paper chart maintained by the health clinic.) Client Register records can only be deleted if no associated information has been entered for that client.

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2.3 Client Activation

To activate a client from the client register screen, simply click on the Activate Client button or on the Update and Activate button if you made any changes to the client's demographic data.

To activate a client from the Quick Entry box, type the patient's chart number or client id number in the box and press the enter key.

Once a client is activated, their name, age, and chart number will be displayed at the bottom of the screen. Any data that is entered will automatically be added to the active client's record. Another patient can be activated at any time and will replace the previously active client. Some reports offer you the option of running them for the active client or for a different client.

The demographic data for any client can be looked up and/or altered at any time without interfering with data concurrently being entered, so long as there is no accompanying activation. For the client who is currently active, this can accomplished by choosing the Inquire on Active Client or Update Active Client buttons from the people icon. For a client who is not currently active, this is done by searching for that client through the people icon and then choosing the update button to make any changes to their data or the client id hotlink to simply look at their data.

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3. Visit Encounters

When a patient visits a health department clinic, an encounter corresponding to the program area that they were seen in is entered for them. For example, a woman coming in for an annual exam would have a Family Planning/Women's Health encounter entered to record her visit. Patients may have more than one encounter (such as both a Child Health and Immunization encounter) within a given visit.

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3.1 Actions

Four actions can be performed for an encounter: Add, Update, Delete, and Inquire.

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3.2 Components

Encounters generally consist of enrollment information, encounter information, and drug dispensing information.

The enrollment contains data that is not expected to change over time, such as whether an infant had a low birth weight. This information is located in a gray box at the top of the encounter screen and is entered the first time the patient has an encounter in that program area. Enrollment information is displayed on every subsequent encounter screen of that type for that patient and can be updated at any time. Not all programs collect enrollment information.

Encounter information is the record of the patient's current visit. It includes information such as visit type, services, laboratory tests, and when the patient is due back for their next visit. All CPT codes and ICD-9 codes associated with the data entered are stored behind the scenes in the database and will print out on the client's receipt and client ledger report.

HN2 contains an extensive set of edits that help to ensure the reasonableness and accuracy of the data entered. These edits are checked whenever an encounter is saved and an error message box will pop up for each edit violated. When all the edits are satisfied the encounter will successfully save. To see an example of these data requirements, click here for detailed instructions for the Child Tracking encounter.

Drug dispensing information is entered at the bottom of an encounter screen. Administered drugs are not recorded in the drug dispensing section. The Fee Payment Screen is automatically displayed after every successful encounter save. If no payment is due, this screen can be ignored. Receipt printing is not functional in this demonstration version of HN2. However, normally a receipt showing only the bill (i.e. without a payment being entered) could be printed by saving the fee payment with no data entered in the fields.

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3.3 Immunization Encounter and Detail

Vaccines given through the health department are entered through the Immunization Encounter screen. Vaccines given by other providers that are being recorded in order to complete, and thus print, an immunization certificate are entered through the Immunization Detail screen.

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3.4 Pregnancy Related Encounters

Patients are enrolled once per pregnancy rather than once per program through the Prenatal Encounters. A Pregnancy Outcome must be entered at the end of each pregnancy.

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3.5 Contacts

In the Contacts encounter, the Update, Delete, and Inquire functions work with the active client. In other words, choosing Inquire will allow you to see any previous phone calls made regarding the active client. Add allows all the phone calls made on one day by one provider in one program to be entered. Therefore, several phone calls can be added at once, but only one phone call at a time can be updated, deleted, or inquired on.

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4. Employee Initials for Use in Experimenting with HN2

The following initials will be accepted by this demonstration version of HN2:

ACT
Accountant (for Adjust Bill or Payment)
NPR
Nurse Practitioner (Provider initials for encounters)
RNS
Registered Nurse (Provider initials for encounters)
LPN
Licensed Practical Nurse (Provider initials for encounters)
CLK
Clerk (for Fee Payments)
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5. Medicaid/Medicare Billing and Data Submission Modules

HN2 includes utilities for billing Medicaid and Medicare and for submitting data to the state and WIC. Currently, these are run from the district for all counties simultaneously, but they can easily be transferred to the county level. These modules are not included in the demonstration version of HN2 for reasons of simplicity.

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5.1 Medicaid/Medicare Billing

The billing module creates electronic submission files for the Medicaid Family Planning, PCM, Health Check, and DSPS programs. PRS billing is currently under development. Electronic submission files in ansi format (HIPAA compliant) are also generated for billing Medicare for flu and pneumonia vaccines.

The billing module contains a complete set of reports for obtaining claims listings and summaries, Medicaid or Medicare number errors, and claim processing errors. A utility for manually entering remittance advice information, specifically, denied claim error codes, for any given claim or batch is included. Specific error codes can be flagged for automatic rebilling if the encounter or client demographic information for the denied claim changes in HN2.

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Data Submission

The data submission module creates electronic submission files for reporting Family Planning and Immunization (MHAR) information to the state. WIC TAD files are also created through this module and WIC VPOD reporting files are currently under development and nearing completion. Complete listings for each of these submission files are automatically generated and can be obtained as reports.

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