MyMedical Ltd, running three walk-in clinics for Laya healthcare, Ireland's second-largest private health insurer, grappled with the knock on effects of manual medical claims.
Manual patient registration led to overcrowded waiting areas and unnecessary pressure on dedicated reception staff. Once registered, verifying patient details with insurance providers required labour-intensive cross-referencing of insurer portals.
Data entry, done the old-fashioned way, consumed valuable time and resources, weighing heavily on the shoulders of the already busy staff. During peak times, there were even instances of claim forms disappearing, necessitating additional patient contact and further draining receptionists’ time.
However, despite a huge amount of effort, these paper claim forms were prone to data entry errors, and often rejected by insurers, necessitating more resources as receptionists phoned patients or doctors to fill in the missing details.
MyMedical consulted MedoSync’s expert team to resolve these issues with MedoSync’s Access product - a digital solution that extracts patient care data in real-time to auto-fill a medical claim form.
In this case study, we explore how MyMedical adopted a novel strategy to optimise operations, reduce mistakes, and enhance the overall patient journey.
Benefits of Streamlined Processes
The product was initially rolled out at the end of 2020 in one of the clinics, allowing valuable feedback and insights that proved crucial for refining and optimising the system's functionality. Once the system was bedded in, it was implemented across the other two clinics in early 2021.
Once integrated, the innovative approach addressed the clinics’ pain points head-on.
According to the clinic, these improvements streamlined operations in several key ways including:
- Patients can check-in and complete insurer forms with mandatory fields and digital signatures on their mobile devices, reducing paperwork and increasing efficiency.
- Doctors can access and sign claim forms from any location, reducing the risk of having unsigned claim forms if the doctors are on annual leave or working remotely.
- The system seamlessly automates patient insurance verification, significantly reducing rejection rates from incomplete or inaccurate forms.
Outcomes of MyMedical's Transition to Automated Claims Processing
MyMedical's switch to automated claims processing has brought several significant improvements:
- Faster Claim Processing: Doctors can now sign over 85% of claim forms within 48 hours, with the remaining 15% taking only two weeks.
- Efficient Staffing: The transition to automation reduced the need for staff handling claims from two full-time employees to just one part-time worker, who reviews claims once a week. This change has saved costs and allowed staff to focus on other tasks.
- Improved Financial Management: The automated system has made it easier to track claims, providing clear visibility into the process and simplifying the work for accountants. This has positively impacted the organisation's financial health.
- Better Patient Experience: Patients can now complete required forms before their clinic visit, saving time. About 50% of visits are now pre-registered and prepared in advance, making the clinic more efficient.
- Enhanced Patient Assessments: The new system includes screening questionnaires for fall risks, COVID assessments, and treatment inquiries. This proactive approach to patient assessment has improved the quality of healthcare services.
MyMedical Ltd's switch to automated claims processing through MedoSync's Access product has yielded significant benefits. This includes faster claim processing, more efficient staffing, improved financial management, a better patient experience, and enhanced patient assessments, and ultimately addressed the hidden costs of manual medical billing.