Affidea, a prominent provider of diagnostic and outpatient services across 16 European countries with 280 locations, confronted two critical issues with its medical billing processes that compromised its financial position: claim form errors resulting in unnecessary rejections, and an inability to monitor the status and outcomes of submitted claims in real time.
Affidea partnered with MedoSync to transform its services using MedoSync Navigator, a digital system that enhances the efficiency of the medical claims process for providers, ensuring prompt payment of claims and maximum reimbursement.
This case study explores how Affidea adopted this innovative method to simplify processes, secure its financial position, and ultimately optimise patient care.
The MedoSync team quickly identified Affidea’s paper-based medical claim system needed an overhaul.
Affidea serves a diverse range of patient groups and payment methods, including corporate patients, cash payers, and those associated with the Health Service Executive (HSE), which means differing deadlines and processes for managing medical claims and patient billing.
Affidea’s manual system risked incomplete claim forms sent to insurers - such as missing signatures or incomplete patient information - and a high number of rejected claims.
Once a claim was rejected, receptionists engaged in time-consuming back-forth phone calls with patients or doctors to chase signatures and to fill in information gaps. Reception staff then resubmitted the claim, manually. This process was inconsistent amongst reception staff, especially when new team members joined.
The cumbersome submission process often resulted in reimbursement delays or, in some cases, no reimbursement.
Affidea introduced a tailored version of MedoSync’s Navigator product. The system means that walk-in patients can fill in an online submission form with mandatory fields and digital signatures, an intervention that immediately reduces the numbers of incomplete forms or missing signatures.
The new system integrates with insurer application programming interfaces (APIs) to enable real-time tracking of claim progress and automated follow-up processes, reducing the need for manual follow-up calls and enhancing patient experience who can complete the paperwork at a convenient time.
The system also integrates with an automated payment platform that charge based on the membership level of cover to ensure accurate billing. Any payments are then linked to specific claims, ensuring that clinics are appropriately reimbursed.
The impact of working with MedoSync
After implementing Navigator, Affidea achieved significant improvements in operational efficiency, data accuracy and financial tracking
The Navigator system tackled specific pain points and transformed the way the clinic managed its processes, leading to smoother operations, enhanced financial performance and better patient experience.