Srihari Leelakrishnan

DENTIST INFORMATION SYSTEM

GLOSSARY Word Patient Procedure Provider, Dentist Claim, Insurance Claim Insurance Company, Insurance Provider Procedure Type Account Number Staff Member Meaning A person who visits the dental clinic to undergo a procedure. It is a treatment that is provided to a patient by a provider A person who actually does the procedure to the patient Its a process that allows the provider to collect his treatment cost for a patient from patients insurance company A company that pays the dentist for the treatment he/she provided to a patient on his behalf. Defines a procedure. (e.g. Filling, Basic Examination, Whitening) A unique number assigned to a patient used during claim process. A person who works for the provider to help on his day to day activities.

Srihari Leelakrishnan USE CASE DIAGRAM

Srihari Leelakrishnan Brief Description The Search Patient use case enables the staff member to find the patient in the system.

Brief Description The Create Patient use case enables the staff member to add a new patient detail in to the system.

Brief Description The Edit Patient use case enables the staff member to change an existing patient detail in the system.

Brief Description The Delete Patient use case enables the staff member to delete an existing patient from the system.

Brief Description The Create Insurance Company use case enables the staff member to add Insurance Company detail in to the system.

Brief Description The Edit Insurance Company use case enables the staff member to change an existing Insurance Company detail in the system.

Brief Description The Delete Insurance Company use case enables the staff member to delete an existing Insurance Company from the system.

Brief Description The Generate New Claim use case enables the staff member to create an insurance claim details for a patient and submit it to the insurance company.

Srihari Leelakrishnan Brief Description The Edit Claim use case enables the staff member to change existing insurance claim details of a patient in the system and re-submit to the insurance company.

Brief Description The Delete Claim use case enables the staff member to delete an existing insurance claim of a patient from the system.

Brief Description The Create Procedure Type use case enables the provider to add new procedure type details in to the system.

Brief Description The Edit Procedure Type use case enables the provider to change an existing procedure type details in the system.

Brief Description The Delete Procedure Type use case enables the provider to delete an existing Procedure Type from the system.

Brief Description The View Claim Report use case enables the provider to view and print details of the claims that are processed in the system.

Brief Description The View Patient Report use case enables the provider to view and print details regarding the patient(s) details in the system.

Brief Description The View Other Report use case enables the provider to view and print other details that are in the system.

Srihari Leelakrishnan USE CASE DESCRIPTION Use Case Name: Generate New Claim Brief Description: The use case enables the staff member to create an insurance claim details for a patient and submit it to the insurance company. Trigger: Patient visits his dentist to get certain procedure(s) done. Actors: Staff Member Pre-condition: Patient has completed his visit and was treated by the provider with certain procedures. Provider has set the Procedure types and its base cost in the system. Post condition: A successfully submitted insurance claim. Basic Flow: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Staff member enters patient information. (Name or Address or Phone) System finds patient and display the patient information. Staff member verifies patient. Staff member verifies insurance information associated with patient. Staff member initiates a new claim with patients insurance company. System generates a claim form with patient name, account number, provider, and insurance provider information pre-populated. System sets the status of the claim to Initiated. Staff member verifies the pre-populated information in the form. Staff member enters all the information required for the claim in the form. Staff member enters the claim date; choose the procedure type from a list provided by the system. System populates the description, base cost for the chosen procedure type in the form. Staff member enters the Procedure Adjustment Cost. System calculates the total cost for the procedure type and the total cost of the claim. Repeat step 10 to 12 for all the procedures provided to the patient during this visit. Staff member indicates the end of his procedure entries. System submits the claim details to the respective Insurance Company Claim Information System. System receives an acknowledgement from the Insurance Company Claim Information System. System sets the status of claim to In Process.

Srihari Leelakrishnan Alternative Flows: 2.1 System cannot find patient. Staff member adds patient using the use case Create Patient. 3.1 Staff member needs to update Patient Details. Staff member edits patient using the use case Edit Patient. 4.1 Staff member needs to update Insurance company Details. Staff member edits insurance company using the use case Edit Insurance Company. 8.1 Staff member needs to change the provider. Staff member choose the provider from the List provided by the system. 12.1 Staff member needs to change the Description. Staff member enters the new description on the form.

REFLECTION: I am overwhelmed after completing these above tasks. Initially I felt challenging to apply my thought process to understand the overall system, I overcome those by walking through my personal visits to my dentist and what procedure they followed during my visit and so on. Another thing I felt was to gain back my experience that I had in generating these requirement documents in my early years of my career where I have played the analyst and developer roles in few of my projects. By working through these tasks, I started to apply the principles of sketching the ideas and refining them throughout the final process. I would certainly try to apply these principles I gained from this home work in future projects as well.