About Client

The client was a dental FQHC in California who wanted a secure, HIPAA compliant system to process claims. The organization was a healthcare claim management company using a conventional pen and paper-based system to carry out the claims processing, which was slow, inefficient, and prone to errors. The client needed the solution to be usable across doctors, nurses, as well as payers to manage dental patients. The solution had to be custom developed according to client’s specifications. 

 

About client

Challenge

About client

Managing Reimbursements

About client

Manual Claims Management

About client

Paper-Based Processes

About client

Higher Claim Denials

About client

Greater Unpaid Bills

About client

HIPAA Compliance

Solutions

Automated Claims Processing

This is one of the focal points of the solution that the client needed. OSP developed an automated system to handle the workflows surrounding the processing of claims. The conventional method was slow, prone to mistakes, and unproductive. Automation greatly minimized the human element from the procedures, thereby minimizing errors, improving the speed, and finally, the revenues. 

 

Coding Automation

Medical coding forms one of the cornerstones of the entire healthcare industry. Every clinical visit is coded and the claims are filled out. This is where most of the errors occur, costing the provider precious revenue from payers. OSP’s solution automates the coding process and also ensures that the codes used are all updated.  

Analytics

When it comes to managing medical claims, it is necessary to know the pattern of denials, rejections, and approval of claims. OSP’s solution also includes a feature to analyse the claims to help the client harness useful insights. This enables the client to determine the cause of rejections, denials, and know the patterns regarding payers. It helps in making informed organizational decisions. 

 

Reduction in Unpaid Bills

The result of automating coding and claims processing workflows is a drastically lower rate of denials and rejections. As a result, the organization experienced a marked reduction in the number of unpaid bills. Needless to say, this improved its revenue cycles, while also reducing overhead because of automation. It’s a win-win for all stakeholders involved 

 

HIPAA Compliant

OSP is well aware of the rules stipulated by the Health Insurance Portability and Accountability Act (HIPAA). The entire solution that we developed for our client in California is HIPAA compliant and promises reliable measures to protect the privacy and integrity of medical data. OSP has undertaken thorough testing to ensure compliance. 

 

Higher Revenues

There are various reasons for claims to be denied or rejected by payers. This is perhaps the biggest reason for providers not getting paid. OSP’s solution leverages the latest technology to automate the claims lifecycle to ensure that they are all proper, thereby reducing the chances of missed reimbursements. Moreover, the client didn’t have to hire any additional staff for the claims management. Timely reimbursements and lower overhead mean higher revenues. 

 

About client

Results

Result

Higher Productivity

Result

Automation

Result

Minimal Errors

Result

Regulatory Compliance

Result

Return on Investment

Result

Analytical Insights

Additional Case Studies

About client

Advanced Homecare Management

We developed a cutting-edge mobile app with geo-tracking and scheduling of doctors, and a payment module with a telehealth solution for a healthcare staffing agency. Winner of the 'Fast 100 & Innovation Award' by Houston Business Journal.

About client

Bluetooth-enabled Golf Coaching IoT App

OSP built an IoT-powered, Bluetooth enabled wearable device to go with a golf coaching app that corrects the users’ swing, stance, posture, and technique. It’s been a success with aspiring golfers.

About client

Advanced Investment and Trading Solution

OSP developed an investment application to cater to the capital markets for a US-based client. It offered portfolio management, macro and micro analysis, performance management, and predictive analysis of markets based on the users’ portfolio.

See All Case Studies

Let's Work as ONE Team

Please share your requirements, and our team will get back to you with recommendations, resumes, or estimates within 48 hours