ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
2.1.0 - CI Build

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Requirements: AS.9.5 Support Financial Claims & Encounter Reports (Function)

Active as of 2024-11-23
Statement N:

Support interactions with other systems, applications, and modules to enable the creation of claims and encounter reports for reimbursement.

 Description I:

Retrieves information needed to support claims and encounter reporting. This reporting occurs at the appropriate juncture in the encounter workflow in a manual or automated fashion. For example this could occur at an initial, interim or final billing. The system may also present the information that is provided for audit and review.

 Criteria N:
AS.9.5#01 SHALL

The system SHALL provide the ability to render available information needed to enable the creation of claims and encounter reports for reimbursement.
AS.9.5#02 dependent SHALL

The system SHALL provide the ability to capture and render available data as required for audit and review according to scope of practice, organizational policy, and/or jurisdictional law.
AS.9.5#03 MAY

The system MAY provide the ability to render available data in a computer readable form when needed to enable the creation of claims and encounter reports for reimbursement.
AS.9.5#04 MAY

The system MAY provide the ability to render data, using either internal or external reporting tools, to support coding of diagnosis, procedure and outcomes.