major component

HMOs, unlike PPOs, require a great deal of labor to be performed by  the provider’s staff. Pre-approvals are a major component of this labor  for events such as specialist-based consultations from those that are  in-network and out-of-network, letter generation, appointments, and even  facility approvals for tests such as those within the radiology domain.

Some of this labor is handled electronically, such as the  ANSI X12 270 standard that involves eligibility, coverage, or benefit  inquiry. Others such as letter writing and scheduling involve elements  from within a Document Management platform or Practice Management  Systems (PMS).

To support this Discussion, search the Internet for information on HMOs  and PPOs, such as can be found at the Health Insurance Web site

http://www.agencyinfo.net/iv/medical/types/hmo-ppo-pos.htm

In this Discussion, answer the following questions:

• What are the technical challenges of a medical practice  that engages in electronic transactions, document management, and  scheduling but also uses analog forms?
• How are the IT needs for an HMO and a PPO different?
• How can the IT needs for an HMO and PPO be integrated,  especially if there is not one overarching HIS Application handling it  all?
• NOTE: it should be in APA format topic, subtopic to all question, In text citation and reference as well.