HIM

WHAT IS HMO INSURANCE?
A health maintenance organization, or HMO, is a type of insurance plan that contracts physicians and healthcare groups to provide healthcare services to the subscribers of the HMO.
HOW DOES AN HMO PLAN WORK?
HMO plans operate on a network basis. The network is a group of providers who are contracted with your insurance. In most cases, HMO plans only cover care provided by these doctors, labs, and hospitals.
You’ll be required to choose a primary physician that you see for most treatment. When you need to see a specialist, you will need a referral.
BENEFITS OF AN HMO PLAN
The initial benefit of an HMO plan is the fact that it costs less than other types of health insurance, including preferred provider organizations (PPOs).
You may also enjoy improved access to healthcare, encouragement to get low- or no-cost annual physicals, and a wider network of generalist and specialist physicians.

Prescriptions also tend to cost less because of group buying power. Typically, billing is more straightforward because health insurance companies negotiate the cost of services with the healthcare provider prior to entering into a contract.
LIST OF BEST HMO IN NIGERIA
Reliance HMO
Hygeia HMO
RedCare HMO
IHMS HMO
Health Point HMO
AIICO HMO
Hallmark HMO
Metrohealth HMO
Greenbay HMO
Total Health Trust HMO
Roding HMO
Anchor HMO
Swift HMO
Lifeworth HMO
Sterling Health HMO
Novo HMO
Multiplan HMO
Princeton Health Limited HMO
Defence Health Limited HMO
Healthcare Security Limited.

CLINICAL CODING : is the process by which some clinical information about the patient are transformed into codes to enable grouping of medical activities in a limited number of categories that are easy to process, store and analyses.

INDEXING OF DISEASE AND OPERATION : is defined as a process of listing on a card of specific disease or operation entities according to a recognized classification.

Clinical coding is a composite source of group of records classified under one code number in a uniform terminology to facilitate quick and easy access to patient’s morbidity and mortality data for quality treatment, adequate statistical report, teaching and research.

coding enable uniform data collection and analysis as well as meaningful comparisons between countries. It’s strengthening the recording and reporting system which increased efficient health information management system, increased advocacy for and awareness of a uniform coding system together with adequate capacity building of physician codes and other allied health and information technology personnel would have the way valid and reliable health information management system.

The essential element in making a correct clinical coding and indexing is the allocation of each diagnosis or procedure in the group category to which it belongs and under pinning the general concept for the quality in clinical coding.

Modernization of health care involves the continuous guidance towards quality standard of both medical acts itself and adjacent activities coding and indexing is one of the key component of the coordination process for all stakeholders and has a major impact on health care service monitoring but also on morbidity assessment and estimate regarding their continued orientation towards quality standard of the medical arts. It is one of the key component of the process for coordination of all health system actors that are involved in providing or financing health services, it has a major effect on health care and provide monitoring activities.

To achieve a high level of date quality that represent a solid support for decision making teaching, research at the hospital, the coding process must be of standard.
Clinical coding is the translation of clinical statements into alphanumeric codes, typically four characters in length.

PURPOSE OF CODING:
Is to standardize the recording of clinical information to enable datasets to be analogous. International Classification of Disease and Related Health Problems (ICD).
According to World Health Organisation (WHO, 2012), clinical coding is defined as the translation of diagnosis of disease, health related problems and procedural concept from text to alphabetical numeric codes for easy storage retrieval and uniformity of comparison and analyses. It also group aspect of patient information and characteristics into categories based on established critic’s logic and convention. These categories used for range activities that underpin the delivery of health services. These activities include but not limited to: Health service planning, Patient quality and safety monitoring, Development and ongoing maintenance/execution of funding models and Research and epidemiology.

USES OF CLINICAL CODING:
Clinical coding and classifications are used in the following service categories: admitted care, sub-acute and non- acute care, non-admitted care, and mental health and emergency care.