Payment Calculation: is full automation possible?
Presented by MCT Technology
Child Care I Your Passion I Our Mission
Child Care I Your Passion I Our Mission
Our Million Dollar Question !
Sorry, No !
Agenda
Who Are we? CareControl 3.0 Birth Story 1st Milestone Challenge
Payment Engine Design Approach
What Did We Learn How We Do It Sharing Outcome Q&A Who Are We? Our Mantra Customers
Innovation
Thinking Long Term
3 offices
390 >>>
Focus
Birth Story of CareControl 3.0
>>> 2009 – 2010 The Making: Pregnancy & Delivery
2010 ‐ 2011 Now The Baby
2011 – NOW >>> 1st Milestone – Payment Problem
Solution – Our Vision 1st Milestone Validation
Foundation Title5, ED Code, Mgmt Bulletin, Agency Rule
Unique Possibilities
152,352
Year
Total
443,474
2007‐2009
Occurrence (3yrs) > 3 times Stage 1
1,858
Dual Staff Validation
CDE
3,215
Thousands of Hours Payment Automation
91.5%
Thank You Not Just The Calculation Authorization Process Cross‐Department Collaboration Calculation Rule QA
Junk In, Junk Out
Don’t Automate Something Wrong
Process
Process – EDMS Helps
Dual Monitor View Process
Process
Process
Process
Cross‐Department Collaboration
WE DO NOT WANT THAT
Cross‐Department Collaboration
WE DO NOT WANT THAT
Cross‐Department Collaboration
Agreement SDM
Adjustment Now Last – Let’s Calculate
Sample Claim Process Authorize Care Schedule
Calculate Payment Generate SDM to Case Manager Export Payment Re‐Authorize Care Schedule Generate Adjustment Calculate Adjustment Everyone Is Happy !
Payment Processing Outcome Focus
Authorize
Process Rcvd ‐> Pay
Cross Dept
(SDM)
Cal Automation QA
Before
20+ popups
2‐3 apps
15+ clicks After
7 screens
All‐In‐One
6 clicks 10 minutes
1 minute
1 Day
Email / Phone 2 – 3 apps
1 – 2 Days
15 – 25%
1 – 2 Days 30 minutes
1 Task All‐In‐One
30 seconds
91%
15 minutes One Last Thank You
Open Discussion
THE WINNER IS ……
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