Background
You began the systems analysis phase at New Century Health Clinic by completing a series of interviews, reviewing existing reports, and observing office operations. (Your, instructor may provide you with a sample set of interview summaries.)
As you learned, the doctors, nurses, and physical therapists provide services and perform various medical procedures. All procedures are coded according to Current Procedure Terminology, which is published by the American Medical Association. The procedure codes
consist of five numeric digits and a two-digit suffix, and are used for all billing and insurance claims.
From your fact-finding, you determined that seven reports are required at the clinic. The first report is the daily appointment list for each provider. The list shows all scheduled appointment times, patient names, and services to be performed, including the procedure
code and description. A second daily report is the call list, which shows the patients who are to be reminded of their next day's appointments. The call list includes the patient name, telephone number, appointment time, and provider name. The third report is the weekly provider report that lists each of the providers and the weekly charges generated, plus a month-to-date (MTD) and a year-to-date (YTD) summary.
The fourth report is the statement - a preprinted form that is produced monthly and mailed in a window envelope. Statement header information includes the statement date,head of household name and address, the previous month's balance, the total household
charges MTD, the total payments MTD, and the current balance. The bottom section of the statement lists all activity for the month in date order. For each service performed, a line shows the patient's name, the service date, the procedure code and description, and the
charge. The statement also shows the date and amount of all payments and insurance claims.
When an insurance payment is received, the source and amount are noted on the form. If the claim is denied or only partially paid, a code is used to describe the reason. A running balance appears at the far right of each activity line.
The associates also require two insurance reports: the weekly Insurance Company Report and the monthly Claim Status Summary. In addition to these six reports, the office staff would like to have mailing labels and computer-generated postcards for sending reminders
to patients when it is time to schedule their next appointment. Reminders usually are mailed twice monthly. Now you are ready to organize the facts you gathered and prepare a system requirements document that represents a logical model of the proposed system. Your tools will include DFDs, a data dictionary, and process descriptions.
Assignments
1. Prepare a context diagram for New Century's information system.
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.
3. Prepare a list of data stores and data flows needed for the system. Under each data
store, list the data elements required.
4. Prepare a data dictionary entry and process description for one of the system's
functional primitives