Problem:
  • Policy numbers on the bill do not match insurance patients policy. Credit control team ends up having to cross-check with Rx
  • ICD-10 codes are not displayed on bills (displays code)
  • Not able to delete duplicate bills/claims
  • Don’t see policy numbers in excel reports
  • Not able to print invoices per patient
  • Not able to generate invoices in USD by self-service
  • Sum totals do not tally on corporate invoice/claims
  • Sometimes, sum totals do not show (need to see an example of this)
  • Not able to configure level of detail for the invoice/claims
  • Excel revenue reports needs to tally with pdfs generated (Up to excess of 200K)
  • Not able to download excel reports from metabase
  • Some patients can be processed for a lab on credit payment but not follow through with the clinical process. Will lead to claim rejections. Need a way to identify completed clinical activities (for each service class)
- Not able to determine clients owing in bill payments due to rejected claims / claims with potential to be rejected hence not submittedNote: Team annotates customer details to identify patients in debt but this needs to be automated to avoid revenue loss
Impact:
  • More manual reconciliations and lower productivity in other assigned team tasks
  • Revenue loss from rejected claims
  • Annotations on paper bills have an impact on Nyaho’s brand - also have medicolegal/ethical concerns
Ask:
  • Policy number registered needs to tally with that on bill
* Def need solve each problem above
* Need a way to handle recon on EMR revenue cycle management extensions to confirm which bills are settled. Perhaps integrate the accounting software