How PDM Automates Common Tasks – Part I

There is simply no way any business can survive this day and age without automating mundane tasks.  PDM is no different.  In order to increase efficiency, lower costs, and provide the best service we do automate common tasks that would otherwise be very difficult to handle manually.

Let us consider the following scenario:  Let’s say you are a doctor and you have patients that are close friends or members of your family.  As a courtesy, you would like for any remaining balance of their claims, after insurance has resolved, to be written off.  After all, who wants their mom to receive a bill?  In order to accomplish this task, someone is going to have to monitor those patients to see when they are seen, when their claims are paid, and then write those claims off.  Sounds simple enough, right?  Not really.  In the past, PDM was asked to do this and we weren’t very successful.  We caught most of the claims that needed to be written off but occassionally one would slip by.  After some brainstorming, we came up with a procedure to automate the task.  Using SQL Server Integration Services, a platform designed to Extract, Transform, and Load (ETL) data, we developed a repeatable procedure to find all patients denoted by the provider whose claims have resolved and to write those claims off with a Provider Adjustment.

This first picture shows the overall SQL Server Integration Services package and the steps it entails.  Notice how we email the account manager if there are no claims to write off on that day or if there are.

Each step represents functions that are performed.  Let’s take a look at the step named “Update Claims and Enter Report Items.”

That’s a lot of steps!  Believe it or not, after all that has run the claims for all patients found have been written off.  We currently do this for 18 of our clients (as of this writing) and it takes the entire process about 3 minutes to run and we do this every day at 6am.  That’s nothing compared to the hours we were spending before in raw labor.

If you are a new provider and you often find yourself seeing family members of friends in your practice, you should ask us about this service.  It’s free of charge!

James

 

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