Rincon India Solutions Pvt. Ltd.

Tag: Health

  • FileDirector For Hospital’s Health Insurance Process Automation

     

    Many hospitals these days offer cashless hospitalisation. This means that a policyholder who is covered under medical insurance will be able to avail of services at these designated hospitals and their bills would be settled by Insurance Company or their TPA (third party administrators). This saves the policyholder/ immediate family’s blocking of money.

    FileDirector software from Spielberg, Germany would be a good fit to streamline the document exchange process which happens between hospitals and Insurance / TPA companies.

    FileDirector will check for prerequisites and inform whether the machine has sufficient rights for installation, operating system compatibility and if the required ports are open.

    The FileDirector server component will be installed on either

    • Windows 7 or above desktop
    • Windows 2008 or above server

    The FileDirector software will run with SQL Express Database which is free of cost. It will install this component in case it is not there on the FileDirector server.

    The hospital insurance desk will have FileDirector scan station license. It is assumed that the Hospital would have reasonably stable internet connectivity to send / receive documents.

    Hospital will get standard cabinet structure for health insurance records. The structure would include mandatory fields such as Name of the patient, Admission Number, Mobile Number, Policy Number etc. as per Insurance company requirements. Broadly speaking these would be common across all Insurance / TPA companies.

    Hospital would get Masters such as Document type which could include but not limited to pre-authorisation application, Query, Response to query, Approval letter, Letter of denial etc. Masters of Insurance Company as well as TPA would be provided for easy indexing.

    Insurance Desk user would be able to scan / drag and drop the document in FileDirector, Index and send the same to Insurance / TPA company. Option will be available to Scan / drag and drop the document in FileDirector, Index and Hold. He or she will be able to add more documents to make this document set complete and then send to Insurance / TPA company via Email.

    Insurance desk user will have an option to print acknowledgement letter for the patient confirming receipt of the number of documents that have been submitted for Insurance processing.

     

    Reports:
    The system would be able to generate different reports such as:

    • Claims processed today
    • Pending as of today
    • Approved today
    • Rejected today
    • Rejection with reason
    • Partial approved with reason

    View
    View for checking insurance company’s incoming email messages / documents would be provided using IMAP integration. Insurance desk user will index and store these incoming messages in FileDirector for future retrieval.

    Search
    Users would be able to search documents using one or more indexing parameters and see records.

    For more information e-mail us on sales@rincon.co.in and we will be glad to assist you.

     

     

  • Reblog: A slice from Evelyne’s life, executive assistant in a hospital specializing in cardiology

    In my work, I interact with many institutions in the health sector. I meet and have discussions with people who handle a great deal of medical information. I take the time to learn about their daily lives. I enjoy it when they share their experiences and stories with me.

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    Evelyne held a number of positions in various hospitals (in health care and economic services) before becoming Executive Assistant in a hospital specializing in cardiology. She quickly discovered that the hospital had to manage a large number of fax documents of all types (medical notifications, insurance case takeovers, analyses results, care sheets, history certificates, intervention approvals, radiology reports, various test requests or results, purchase orders, invoices, etc.).
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    It became increasingly difficult to handle them effectively. Many documents were lost and others were sent to the wrong recipient or forgotten near the fax machine in full view of everyone. With such a volume of documents piled up in the filing cabinets, searching for a fax was lengthy and tedious.

    It was then that Evelyne remembered that the hospital where she had worked a few years prior used a fax software solution instead of traditional fax machines. Showing initiative, she decided to talk to the hospital IT director about it. Aware of the problems associated with the processing of documents sent and received by fax, he dealt with the problem. He quickly approved the idea of replacing the fax machines and fax boards by a software solution.

    This is how the XM Fax® solution was adopted, to the great delight of Evelyne, her co-workers, the IT department and management.

    Evelyne can now send and receive faxes from her work station, her messaging device and her electronic medical records. The processing of faxed documents has thus become much faster and she saves a lot of time. She no longer goes to fax machines many times per day. Evelyne is more productive and effective. She can focus on her mission, which is to provide quality services to patients and to ensure the absolute confidentiality of their personal information. Incoming faxes are now forwarded to the correct recipient without any human intervention, thus limiting unauthorized viewings of health-related personal medical information by the wrong person. With XM Fax, confidential documents of various types are routed to mailboxes or network folders belonging to approved recipients and to designated secure printers.

    As for the IT director, in addition to optimizing his telephone and IP network, it has drastically reduced his expenses related to the use of fax equipment (fax machines, fax boards, maintenance, ink, paper, and telephone lines), and has made it possible to better control the flow and security of communicating by fax. His team is now equipped to administer, monitor and track all the operations and actions carried out in connection with fax transmissions. She can avoid any unauthorized viewings, including those carried out by the administrators themselves, create audit trails, and report to the hospital management. Furthermore, since the hospital is equipped with a high availability redundant fax solution, service continuity is assured. In addition, the advanced and integrated control features of the fax server, the encryption, and the management for users/administrators, meet the requirements of the medical sector in terms of security and compliance. This solution is gaining popularity within hospitals in expansion. Fortunately, this system is scalable to handle a larger volume of faxes and thus serve more departments and employees.

    Today, thanks to Evelyne’s initiative, the hospital is optimizing its unified communications infrastructure, reducing its costs, and increasing the productivity of its employees. Above all, the healthcare organization is now able to process its patient records quickly and in a completely secure manner.

    This truly inspiring account proves to me that any person, no matter his or her hierarchical position, can influence the course of events within the organization in a positive way.

    The original article can be found here.

    For more information e-mail us on sales@rincon.co.in and we will be glad to assist you.