CHAPTER 5

NEW CENTURY HEALTH CLINIC

Data and Process Modeling

Assignments

1. Prepare a context diagram for New Century’s information system.

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 2. Prepare a diagram 0 DFD for New Century. Be sure to show numbered processes for
handling appointment processing, payment and insurance processing, report processing,
and records maintenance. Also, prepare lower-level DFDs for each numbered process.

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 3. Prepare a list of data stores and data flows needed for the system. Under each data
store, list the data elements required.

DATA FLOW DATA STORE DATA ELEMENTS

PATIENT INFORMATION PATIENTS DATA PATIENT NUMBER
PATIENT UPDATE PATIENT LAST / FIRST NAME
BIRTHDATE
HOUSEHOLDER
LIST OF SERVICES / CLINICAL
HISTORY
APPOINTMENT PATIENT APPOINTMENT DATA CODE NUMBER
REQUEST DATE NUMBER
APPOINTMENT LIST PATIENT NUMBER
SCHEDULE SERVICE CODE NUMBER
CPT CODES MEDICAL STUFF CODE
INSURANCE NUMBER

INSURANCE CLAIM STATUS APPROVED INSURANCE NUMBER

PENDING EMPLOYER NUMBER
DENIED CLAIM NUMBER
PAYMENT NUMBER

HOUSEHOLD DATA NUMBER

HOUSEHOLD UPDATE FIRST / LAST NAME
HOUSEHOLD LAST NAME
ADDRESS
PHONE
INSURANCE
EMPLOYER
CHARGES
PAYMENTS

INSURANCE DATA NUMBER

INSURANCE UPDATE NAME
INSURANCE PAYMENTS ADDRESS
INSURANCE REPORT PHONE
PAYMENTS
REMINDER POSTCARD
REMINDER POSTCARD DATA
MEDICAL STAFF DATA
MEDICAL STAFF UPDATE
MEDICAL STAFF REPORTS

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 SERVICE CHARGES INVOICE AMOUNT HOUSEHOLD NUMBER
CHARGES APPOINTMENT NUMBER
CPT CODE
PROVIDER NUMBER
FEE

PAYMENTS DATA PAYMENT SERVICE HOUSEHOLDER NUMBER

DETAILS PAYMENT DATE
PAYMENT AMOUNT
INSURANCE

SERVICE COMPLETED COMPLETED SERVICE PATIENT NUMBER

APPOINTMENT NUMBER
PAYMENT STATUS
MAILING LABEL DATA PATIENT NUMBER
FIRST / LAST NAME
HOUSEHOLD NUMBER
FIRST / LAST NAME
ADDRESS
EMPLOYER
CHARGES

REPORTS OFFICE AREA

STAFF REPRESENTATIVE
DATE

4. Prepare a data dictionary entry and process description for one of the system’s
functional primitives.

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 “CREATE A PATIENT INVOICE PAYMENT”

PURPOSE: To present detail of services, charges and payments.

INPUT DATA FLOW

 PATIENTE SERVICES
 INSURANCE PAYMENT
 EMPLOYEER PAYMENT
 PATIENT DATA

OUTPUT DATA FLOW

 CHARGES AND FEES
 PATIENT PAYMENTS BALANCE

PROCESS DESCRIPTION

For each INVOICE PAYMENT from PATIENT SERVICES

Retrieve INVOICE NUMBER from PATIENTS
Verify PATIENT NUMBER and INVOICE NUMBER
For each SERVICE in INVOICE Verify INSURANCE and EMPLOYEER PAYMENTS
Add CHARGES AND FEES in PATIENT PAYMENT BALANCE

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