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Case Studies

INDUSTRY Healthcare

SOLUTION
MS Visual C#, MS ASP.NET, MS SQL Server 2012

Challenges

Our client is a Healthcare organization based in Philadelphia, USA. The organization provides primary care healthcare services through its Seven branch. In the past they use a custom develop application to capture patient financial information like patients visits, patient invoices, track patient balances, coordinate with insurance companies.

Previously the client held information on a number of disparate systems. Data was held in individual clinic and as the clinics grew, this became increasingly difficult to manage. It became very difficult to view and maintain data. On the Other hand, searching data for analysing business critical information was time consuming. Their insurance model was quite complex which include multi parties.

It was recognised that their current infrastructure did not support their needs and so the decision was made to invest in a new system. They want a system which help them with Patient Accounting such as insurance billing revenue, statistical reporting, accounts receivable and collection follow-up.

Solution

Client selected Octaware to improve features and functionality of Sifacare – Patient Accounting System. Octaware developed a comprehensive web based solution that streamlines the patients accounting. Sifacare helps them to simplify registration, patient and insurance billing, revenue and statistical reporting, and accounts receivable and collection follow-up.

Sifacare helps capture the right information from the moment a person walks in the hospital doors, so we can provide insurance companies and patients with a clear view of costs. This application automates a range of tasks to maximize the efficiency of clinic staffs.

With patients accounting system in place client have streamline processes for insurance eligibility verification, prior authorization, referrals system, claims
management which including status tracking and denials as well as Health plan payment processing and coordination of benefits.

Benefits

  • Lower administrative cost as application provide single place for claims: Electronic, Paper, Primary, Secondary, Professional, and Institutional
  • Freed up valuable resources and lowered the cost.
  • Improved business productivity and efficiency through centralized database.
  • Increased grant application approvals due to better access to required information to complete claim application.
  • Enhanced customer service with business intelligent reports providing status of insurance claims management
  • Prevented risk and regulatory exposure by maintaining data integrity.
  • Simplify claims management by tracking claims every step of the way using our dashboard and search tools.
  • Reduce A/R days by correcting and resubmitting claims online