Understanding Problems to Lead Change
The adult population of US is on the rise, and the number of people with multiple chronic diseases is increasing rapidly.
Older patients suffering from such chronic conditions and reduced mobility are in dire need of home-based care management to ensure their independence and dignity.
To manage and optimize the home healthcare workflow with efficient medical scheduling, billing, workflow automation, documentation & reporting, and employee tracking are crucial.
The collected health data must be reported accurately and consistently and must comply with HIPAA requirements that protect patient privacy and prevent frauds.
A US-based client wanted to build a bespoke home healthcare software solution hosted in the cloud. As per the given requirements, the client wanted to incorporate a next-gen medical scheduling feature with an intelligent point of care & employee tracking module. Our client also desired to replace the manual reporting for multiple avenues with automated and hassle-free reporting feature. Advanced billing system to automate claim capturing and reporting was the core challenge needed to be solved.
Defining the Solid Roadmap
The core objective of this project was to simplify the healthcare for patients.
Since the beginning, we have given the impetus on aligning all the modules as per the need of patients with a user-friendly solution structure.
We decided to build the medical scheduling module with 'Add shift' & 'Add Time Cards' feature to mark the precise clock in and clock out time.
To create a comprehensive automated medical claims system, we first started working on the inbound claim form that combines the patient's records with the CPT codes of administered care.
Our finalized system architecture was based on a hierarchical system of administration including Superadmin, agencies, zone management, caregiver, and consumer. The role configuration, permission to access the patient's data and messaging feature were decided to be included as per the proposed hierarchy. Managing the patient's data was critical, and we devised a smarter strategy and employed a special team of healthcare experts to maintain HIPAA-compliance.
Delivering On the Promise
The solutions simplified managing all the hierarchical positions that take an active role in providing streamlines home healthcare solutions.
Any added agency employee can manage pay types, service items, custom prompts, payers, payer classes, observations, activity codes and more.
The solution works on RVV (Required Voice Verification) and EVV (Electronic Visit Verification).
OSP cloud-based solution also enlists a snapshot feature to lock all the tasks completed by the caregiver in a selected date range and to create organized lists of employee timecards for weekly and bi-weekly pay periods.
Our automated system is capable of generating automated reports for RVV recording, authorized Vs. actual report, employee weekly hours overtime report with summery, inactive employee report, custom prompt report and more.
OSP's engineered an advanced billing system as the core feature of our final solution. Our claiming system can pull in data in the client's system to generate claims such as CPT codes, length & date of services and total unit creation. The system can capture claim records and add ICD-10 codes for the administered healthcare and showcase summaries of total billing. OSP' smart billing module also shows all claims and their status, such as received, paid, claim denials and the reason for denial.
Building to Deliver Experiences
OSP has successfully delivered the advanced home healthcare system, using which the client can efficiently and remotely manage patients for home health, home care, hospice and other healthcare organizations.
The time-consuming task like medical scheduling was now completed with just a few clicks. Managing appointments with caregivers based on their location and availability became easy and time-saving.
The billing module uses to create a claim, and list all filed a claim with its status with a feature of automated compiling visits to collect multiple visits claim in a single claim list.
The simplified reporting tools helped the client to grasp the current patterns in administrative, financial and clinical data in order to understand and solve the hidden challenges in home healthcare management.
OSP's cloud-based home healthcare management solution has proven its worth by streamlining the toughest tasks through a simplified web-based solution. The EVV, medical scheduling, messaging, billing, and more in one single platform has solved many administrative problems faced by the client. OSP simply automated the multiple tedious processes and helped caregivers to offer an unparalleled home healthcare service to patients who are in dire need of personalized and efficient healthcare services.
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