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In a significant leap forward for hospitals and community health providers, digital health solution provider DC2Vue has released the latest version of their care coordination suite, which integrates seamlessly with Services Australia and Medicare Online web services.
Revenue cycle efficiency is a significant challenge for hospitals. One of the biggest pain points hospitals across the nation is experiencing with reimbursement, cash flow and the revenue cycle. Service billing and claiming errors can result in denied claims and uncollected service revenue from Medicare and insurance companies, creating cashflow problems. Hospitals are at a tipping point when it comes to the numbers of claims they can follow up on and prior eligibility checks they can request through manual effort.
In the area of medical billing and coding, claims processing is essentially the overall work of submitting and following up on claims. When you’re not helping patients, or interfacing with data and payers, you’ll be managing the basic work of your day which involves coding claims to convert the work of a doctor or specialist into revenue. In other words, the general process of claims submission begins immediately a patient enters a healthcare facility.
To this end, DC2Vue can be your claims billing partner by processing bulk bills, patient claims, gaps and DVA claims from your client’s invoices. Furthermore, you can receive Medicare responses instantly with our integration. Our platform provides real-time claiming dashboards and transaction reports to help reconcile client invoices.
Medicare online integration areas include allied health, community nursing, specialist claims, MBS and DVA verification payment report and payment processing functions and more.
The DC2Vue platform offers client management and care coordination within standardised care pathways, identifying an appropriate sequence of actions, timeframes, goals and expected outcomes for better client experience.
"With a lot of the health service providers we talk to there's an emphasis around claim rejections and how to work those rejections and mitigate them to the front end. Our solution help them correct actions before claims are rejected." said Nalaka Withanage, Chief Technology Officer at DC2Vue.
“In most cases, a hospital or health service invoices Medicare directly for services rendered to patients and this payment system is cumbersome because they are not integrated with Medicare online.”
At the same time, Medicare has recognised this situation and will replace existing legacy adaptor technology in 2022. “We have been working with Medicare over the last few months to integrate DC2Vue with Medicare Online web services,” said Nalaka.
“As such, through DC2Vue, we can offer hospitals and health services seamless integration with Medicare Online.”
Avoiding expensive short-term fixes
“By working with DC2Vue now, organisations are future-proofing their claiming systems against potential Medicare changes,” Nalaka explains.
“In contrast, DC2Vue is future-proofing our clients because we use Medicare online web services within our digital care coordination suite digital claiming and data channels that are secure and stable, now and into the future.
“However, another benefit of switching to us is that we can help speed up their claiming, as claims management is a core module of DC2Vue. Medicare integration is not an add-on, and hospitals also benefit from our referral management modules that connect referrals to patient care plans, appointment scheduling, and then the billing.
“If an appointment is not connected to the billing scheduling, breakdowns in revenues may occur.”
Addressing digital care pain points
Undoubtedly, people come to us for help with digital care coordination for myriad reasons, Nalaka advised.
"There could be several signs your health service is in trouble such as a low patient engagement, clinician burnout or the ongoing struggle to produce statutory reporting.
"Apart from these warning signs, adopting digital health to transform care delivery is a huge opportunity."
Telehealth, home health monitoring and digital medical records are perhaps the most transformative digital health initiatives over the last few years in Australia.
But digital clinical transformation is challenging, and effective healthcare solution delivery requires a deep understanding of patient journey mapping, clinical documentation, digital health standards, statutory reporting, HL7, Cloud AI, data security, UX and machine learning, Nalaka noted.
This level of knowledge is usually beyond the internal expertise of most service providers, so it's unsurprising that many are choosing a technology partner to smooth the way to clinical transformation.
Nalaka adds, "This is a smart move unless you get the wrong technology company who does not understand the healthcare process and standards. You can avoid these challenges by choosing DC2Vue as your trusted technology partner."
End-to-End Care Coordination
DC2Vue is a proven end-to-end care co-ordination software suite empowering over 6,000 clinical and administration teams in acute, mental health, aged, and community health settings. By seamlessly combining people, processes and data, decision making is instantly improved, be it clinical, operational, or financial.
Our solution can also take the referrals and carry out care coordination and care planning processes, make the appointment, handle the financial elements, and track the document processes including client invoicing and statements.
DC2Vue Medicare online claiming module helps healthcare professionals to use digital technology to perform automatic eligibility checks keep track of medicare claims through the entire client lifecycle. This support ensures payments are collected and denied claims are addressed.
For more information about how DC2Vue can streamline your revenue cycle management process with Medicare, get in touch today.