The Medical Billing Framework as the Backbone of the National Health Information Infrastructure

TL;DRAbstract

<em>Given the medical billing framework and proposed meaningful uses for the national health information infrastructure, this paper shows how the billing framework can strategically help achieve meaningful uses quickly.</em> The existing medical billing framework has national connectivity, and its existing communication, data, and authentication standards are sufficiently expandable to serve as a necessary backbone for a national health information infrastructure. Doing so offers strategic advantages: (1) providers are already <em>wired</em> and using the billing framework, processing billions of claims a year; (2) the mechanism to check patient insurance eligibility can easily expand to additionally provide relevant patient information (e.g., problems, medications, and allergies) at the time and place of service; (3) a national program already exists that captures quality measures through claims processing; and, (4) payment incentives on claims can drive ongoing provider compliance. G

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