Mobile Billing App for Healthcare Provider
PayMed is a mobile billing application designed to streamline the billing and processing of medical payments in the provinces of Canada.
Background
Customer Request
Challenges
- The long procedure of medical specialists checkWhen registering, the doctor was required to indicate the medical practice card number. To be admitted to the billing system, a doctor had to have accreditation and licenses, which could only be verified through a request to the Ministry of Health of the respective province. It was time-consuming, and users lost interest in the application.
- Outdated information on system billing codesWhen billing through the billing system, the confirmation and payment by the health insurance center are possible only if the payment requests are correctly formed with the appropriate codes. In the context of constant changes in the database, a manual updating of such codes would take a lot of time, and errors could lead to the freezing of compensations from the Insurance Program.
- Differences in the legislative framework for different provincesThe process of code selection, billing, preparation of an accompanying documentation set, and payment requests vary significantly between regions of Canada. It complicated the billing procedures of the system and created many errors when making payments by insurance companies or patients.
- The difficulty of patient data enteringPatient acceptance, referrals, diagnoses, and payments for services reimbursed by the health care program required identification of each user. An instant data was needed to assess the validity of each patient's Personal Health Number..
Challenges
Solutions
- Synchronization of the billing system with the bases of the Ministry of HealthThe development of a synchronization system for service and provincial databases OHIP, MSP, AHCIP made it possible to significantly speed up identifying a doctor, taking into account the current permits for conducting the medical practice in the corresponding region. It made it possible to significantly reduce the process of registering new doctors in the system and promptly provide them with the ability to issue invoices.
- Parsing code databases of health insurance planFor the regular updating of the Medina service codes, specialists have developed an algorithm for parsing databases. So, constant updating of codes in the billing system allowed avoiding billing errors and maximizing payments for payment requests of medical practitioners
- Development of algorithms for processing requests based on regional criteriaTogether with FTL engineers, the company's specialists created an algorithm that considered all MSP, OHIP, and AHCIP requirements when submitting a payment request for medical services. Each algorithm considered the coding of the service, the set of accompanying documentation, the format of the request, payment procedures, and regulatory requirements for the dates and periods of closing payments. It allowed avoiding duplication of procedures and errors in processing requests for different provinces.
- System integration with health service serversThe implementation of algorithms for integration with patient databases allows you to quickly receive information about the coverage of medical services for each PHN and the patient's medical history, which also simplified and accelerated billing and coverage by territorial insurance services.
Solutions
years of experience of the setter team on construction and household management
repair and household maintenance services platform permits to manage
finananced by investors Due to participation in Reach CANADA 2020 accelerator, the startup
Main features
Cross-analysis system
A cross-analysis system was created to simplify the process of making individual medical reports for each doctor. It allows you to assess which billing codes were most often billed, how many patients were the doctor had during the reporting period, and how much was billed. It helps in the formation of the declarations of each doctor and provides full control over the settlement documentation
Cross-analysis system
Scanning the patient's personal health card
A system for scanning individual patient records was introduced to simplify the patient search process and speed up the billing procedure. It made it possible to increase the control and security of personal data processing and minimize the risk of using someone else's PHN when visiting a doctor.
Scanning the patient's personal health card
