Before turning to the management of patients in the ER, I note that there are some peculiarities in the handling of medical records for some institutions.

Originally we assume that a medical consultation, is associated with only one doctor and a patient, but for some institutions it is necessary that several patients can be associated to one or more physicians, for example in food talks, to name one, on other occasions it is necessary associated with a patient several physicians for the type of treatment applied.

The allocation of appointments depends on several variants, such as specialty, whether it's a first time visit, if subsequent, doctor's agenda, days served, etc.. and defined above appointments are assigned sequentially, ie the first time is had to the first patient and so on, sometimes visits should be assigned randomly in the days and hours attending physicians and even there may be cases where for a few days or specialties assigning sequential appointments and other medical specialties or days to be random.

It is important to know the different variants in which they treat patients to avoid surprises when trying to implement. 

EMERGENCY ROOM

As we know, this part of the institution receives patients in critical conditions that once served may give way to his hospitalization, surgery scheduling, to serve them in the very area because they can not be moved, take x-rays, imaging studies, laboratory and register them even after being treated or practically reference to another medical facility.

Medical Institutions for government involvement applies the concept of recovery fees and the level of the fee payable for the care that patients receive depends on the application of a socioeconomic study but when they arrive at night or at dawn and no staff to implement the study or in spite of presence and the patient was alone and unable to provide information or the person really does not know, then you can apply a preset socioeconomic status while obtaining definitive information.

As we know, every patient is assigned file number for control over the institution, but how to allocate it in the ER when first is unknown if will be retained in the institution, in some cases generates a temporary ID that time is replaced by the file number identification or definitive.

We must not forget that it must cover the monitoring requirements that force doctors to register the patient, the circumstances in which he arrived, his first diagnosis that can be modified later, drugs, healing material, studies, radiographs, etc. . required, this should be recorded for future reference and thereby integrate the patient's clinical record.

From the financial point of view of the recording of accounts receivable may be several situations, I note a few:

• The patient recovers, he was discharged and has no resources to pay all medical expenses, in some cases it is possible to:
  • Forgive of the debt
  • Sign a commitment letter which sets out in periodic payments or a single payment
  • Charge the debt to the insurance company if the patient has insurance
  • Medical bill the institution caring for the patient as part of the benefits of their work.
  • Inactivate the balance until there is a possibility that the patient return again and require the institution to be served again

• The patient recovers and leaves the institution
• The patient died and the family does not have the resources

Finally, the range of variants is large and must be analyzed in detail in the implementation process have the least smooth.