An innovative software solution from leading Australian software developers Bizcaps Pty Ltd is helping a major private healthcare provider streamline their rebate claims processes with increased processing speed and fewer errors.
For private hospitals, rapid and accurate processing of health care rebates for costly items such as prosthetics can have a significant positive effect on cash-flow. However, extracting the correct rebate code for each surgical prosthetic can be a complex and time-consuming process.
One of the country’s major private health providers, Healthscope Limited has now been able to streamline some of the more complex areas of their rebate claims processes to speed up their rebate claims and reduce costly administrative errors.
Operating a network of 48 private hospitals across Australia, Healthscope in a recent quality audit of their prosthesis claim systems discovered that inconsistent practices and a lack of tools were hindering efficiency.
The Commonwealth Prostheses List (CPL) includes over 9,500 rebate codes covering expensive surgically implanted items that range from cardiac pacemakers and stents, items used in hip and knee replacements, intraocular lenses to even human tissue such as heart valves and corneas.
Around 30 surgical hospitals search every day for anything from ten to a hundred CPL rebate codes following surgery, and Healthscope racks up a $200 million spend on prosthetics across the group each year.
Warwick Potts, Supply Operations Manager for Healthscope explains that the CPL pricing information is fed into their systems every six months, containing only a rebate code without actual product information. Several hundred thousand products exist and one rebate code may cover fifty items.
He adds that though administration staff searches for information on the product packaging, the Australian CPL rebate codes are not printed on it.
The Bizcaps MCIS software will allow Healthscope to link into the NEHTA-established National Product Catalogue hosted on GS1 Australia’s GS1net datapool and instantly access the correct rebate code for each product as suppliers populate the data.
Using Bizcaps A1 deployment framework, the system was installed in a matter of days.
Over thirty suppliers have met the requirement to populate this data, with Healthscope waiting on just six suppliers to complete their data fields.
Mr Potts concludes by saying that the Bizcaps solution will enable them to search for real-time catalogue data available live from the supplier, and find the specific rebate code, saving the administrative team a lot of time while ensuring accuracy of information.