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Our journey
Kick Off
CHALLENGE
Automate billing workflow & improve claim approval rate.
EXPLORATION
Gathering resources to enhance the go-to-market strength.
ANALYSIS
Lining up customized system architecture to optimize workflow.
SOLUTION
Customized mental health billing platform hosted in a cloud.
RESULT
Quicker claim processing with a reduction in claim errors.
Iteration
& Support
Our Journey
1
Challenge
Understanding Problems to Lead Change

The recent changes to both diagnostic and procedure codes pose many challenges for behavioral health medical billing.

To solve this challenges, an innovative approach with advanced technology is the must.

The billing process, especially for mental health is complex and staying a step ahead of the current billing challenges needs an intelligent strategy combined with agility.

Screening and treatment of mental health problems and necessary coordination with proper case management are the major hurdles faced by the mental health billing process.

Replacing a legacy system with a modern responsive system.

FQHC Dental Centers billing
fqhc billing guidelines

A Texas-based mental health center wanted to automate the manual medical billing process. The growing concern of this mental health clinic was to improve approval rates which were 10% against 100 claims submitted.

The primary challenge for OSP was to manage multiple insurance providers for a large clinic set up. The client specifically asked to improve

  • Flexibility in billing
  • Workflow automation
  • Accurate claim scrubbing
  • Fill the regulatory compliance gap
2
Exploration
Creative Viewpoints For Right Direction

Mental Health Billing is a very complex process with highly variable requirements for each clinical setting.

Like many new businesses, the client wanted to focus on billing automation more methodically.

OSP knew about the dynamic nature of mental health billing solutions, and we first began by coordinating the compliance readiness assessments and implementation services.

We collaborated with the client to create an accelerated implementation strategy that could produce a 'first glance' infrastructure and allow OSP to start resource gathering within four weeks.

fqhc dental billing guidelines
fqhc guidelines

The mental health billing project scope included feasibility analysis, project management, business analysis, project analysis, user management console development, QA & testing. The clients' existing system was a Microsoft Access. This Database was connected to VersaForm Practice Management Solution which worked as a middleware to process claims. Our first goal was to devise a responsive system that can replace client's current Microsoft Access based system and build cloud-based Practice Management Solution. The proposed system is a web-based system with additional features like:

  • Payment scheduling
  • Email alerts for upcoming services.
  • Accepting direct payment from patients without logging in to the system.
3
Analysis
Defining the Solid Roadmap

We assessed the client situation by breaking down the enterprise into four key areas for analysis: Security, cloud infra and Software, Costs Analysis, and a detailed Assessment Report.

The proposed system replaced only the existing Microsoft Access system with above mentioned additional features and automated process.

We decided our technology stack based on the project requirement and the current market trends.

We employed Visual Studio to develop the web application with Server Technologies such as Amazon cloud and Microsoft SQL Server.

fqhc dental productivity
fqhc dental requirements

For all the user modules, OSP diligent solution team created separate wireframe and prototypes such as admin, patient, provider (doctor), guest for direct payment. We devised a robust system architecture design to develop, deliver and deploy the core product quickly. Scalability was the major take away point from our development architecture. Apart from replacing the current Microsoft Access based system with a new system, we came up with following additional features to make the solution comprehensive.

  • Web-based interface for patient’s Information and claim parameters.
  • Web Application will process information with default.
  • Automated database update before synchronization.
  • Automatics Reporting

Up to this day, OSP continues to develop the product, constantly adding new features and utilizing new approaches to deliver the perfect solution to its end-users.

4
Solution
Delivering On the Promise

At OSP, we employed agile product development methods to build a customized mental health billing platform that easily creates multiple claim case for the multiple types of billing.

After evaluating and enhancing the system infrastructure supporting their databases, we incorporated an automated claim scrubber to check claim accuracy against hundreds of billing and coding requirements.

To fulfill the client requirements, our advanced billing platform provided an easy way to enter procedure codes, modifiers, and bundled codes with the ability to generate a list of CPT and ICD-10 codes.

The tailored billing platform supports legal forms such as HIPAA forms, HCFA-1500, Assignment of Benefits.

We smartly incorporated the ability to create an appeal letter for denials, electronic remittance support for bulk check posting, automatic deposit of reimbursements, and electronic EOB.

federally qualified health center
fqhc dental requirements

As per the client's needs, the mental health billing platform was integrated with multiple EMR of providers settings to bring together patient medical and claim history under one roof. Automated database update before synchronization and seamless data transfer through Versaform Practice Management provided predefined EDI and FTP. Our automated mental health billing solution helped to post insurance payments with assisted ERA payment posting dashboard without tedious data entry.

We tailored solution while ensuring government standards for development from HIPAA & PCI compliant to Robust SSL certification. With our help, the client can now manage claim for different mental health centers with secure cloud support keeping all information backed up.

5
Result
Building to Deliver Experiences

Our customized mental health billing platform was delivered the initial infrastructure according to plan within four weeks and completed the full system implementation to make the final release on time and the budget, within eight weeks.

Our development teams adopted agile methodology and driven the project to the success. Regular discussions and well-adjusted bi-weekly scheduled meetings with the client helped us to keep everything and everyone involved in the loop.

We provided the client with the expertise required to deliver tailored mental health billing platform to automate billing process and improve claim approval rate.

fqhc dental services
fqhc requirements

The traditional billing system was manual, time-consuming and required added efforts. OSP tailored mental health billing solution automated the billing process and helped to improve claim approval rate. Quicker claim processing with a reduction in claim errors was made possible. Extending the flexibility and scale, our software solution increased efficiency for creating multiple claim case for different billing types. Our healthcare software solution architects provided them with advice on how to re-architect and improve the application. The client can now manage claim for different mental health centers with secure cloud support keeping all information backed up.

Explore the Services that are helping our customer to grow
Healthcare Software Product Engineering
Simplifying complex healthcare challenges through technology.
Healthcare Automation
Automating healthcare for a flawless workflow experience.
Healthcare Cloud Solutions
Leveraging cloud computing to build premium healthcare solutions.
Integrated Healthcare Solutions
Integrating systems for seamless healthcare data exchange.
THE HIGHEST STANDARDS.
THE HAPPIEST CUSTOMERS.
"Yes, I would certainly recommend their services because they were diligent and the offered price was very reasonable which is a challenge these days to get a great product at excellent pricing."
- Bert Lurch
OUR GLOBAL PARTNER NETWORK
Forging alliances with top global technology companies to find a new and better way to solve complex healthcare challenges.
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The experience and dedication of the people working at OSP Labs make everything we do possible. If you’re passionate about having a powerful impact on transforming healthcare, we’d love to hear from you.
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