DHSwitch`s status as the leader in electronic claims delivery in South African healthcare is built on the company`s in-depth understanding of the practice management needs of the modern general practitioner (GP).
This understanding requires constant re-evaluation and refinement of the service we provide as well as the development of value-add options geared at enhancing the business practises of our customers. Electronic Claims Profile (eCP), our latest no-cost offering giving GPs access to business critical information on their practices, does just that.
Registering for eCP unlocks a wealth of medical claim funds data for DHSwitch users - from patient encounters, through to common diagnoses, procedures performed, medicines dispensed and claim rejections. This data not only provides the GP with a coherent overview of his/her practice, but empowers him/her to make informed decisions on correcting business process inefficiencies.
The information is presented in the form of easy-to-read, graphically enhanced reports that can be downloaded from the DHSwitch Web site or e-mailed to the GP on a daily, weekly or monthly basis as required. Subscribers are issued with individual user names and passwords to ensure strict confidentiality of information is maintained at all times.
eCP - the specifics
DHSwitch currently offers 10 eCP reports, many with "drill-down" functionality for even more focused analysis:
* Patient encounters: This report details the number of patient encounter claims submitted for a selected period of time by age and gender. The national averages for male and female patients are also included.
* Number of transactions: This report includes all accepted and rejected transactions submitted through DHSwitch. Transactions can also be viewed by specific medical fund.
* Reasons for rejections: This report details the primary reasons for claim rejections, highlighting the most common submission errors. It also identifies solutions to eliminate or correct errors in order to reduce inaccuracies in claim submission data.
* Common diagnoses: The use of ICD codes to determine trends related to clinical information is becoming accepted practice. DHSwitch users can now download this information per medical fund, selecting for quantity intervals from top five to top 20. A drill-down functionality for age and gender for each diagnosis is offered, as are national diagnoses statistics for easy comparison.
* Dispensed medicines: Dispensing GPs can now view the most commonly dispensed medicines in their practices. Medicines can be selected for quantity intervals of top five to top 25 of the most common medicines prescribed. Once again, drill-down functionality as per age gender and medical fund is offered when selecting a specific medicine. Comparative national statistics are also available.
* Procedures performed: This report details procedures executed in the practice using BHF tariff codes. Parameters can be set to report the top five to top 25 procedures and similar to the above drill-down functionality is available. Here again, national comparative statistics are available.
* Consumables used: BHF tariffs are used to identify consumables used over a specified time period. The standard drill-down functionality in terms of gender age and medical funds for the various quantity intervals is available as are national statistics.
* Medical funds receiving the majority of claims: This report details the medical funds that received the majority of electronic claims submitted to DHSwitch by a practice. Data can be sorted according to rand value or transaction line submitted. Once again selection of a specific medical fund enables drill-down functionality for age and gender.
* Medical fund distribution report: This report shows all medical funders that receive claims from DHSwitch against funds that did not receive claims submitted by the practice.
* Average claims submission cycle: This report details the average claims cycle for the practice, from the time the patient was seen until the claim was delivered electronically to the medical funder.
We believe the DHSwitch eCP reports represent an important step forward in improving the business efficiencies of the GP. Correct interpretation of the data can, for example, allow the subscriber to see where the practice stands in terms of claims being rejected or accepted and initiate remedial measures.
Analysis of the claims submission cycle enables the GP to identify where claims are being delayed or blocked in the system, leading to improved turnaround times. The statistics also provide vital information as to developments at the medical funders, enabling better planning. The benefits are indeed boundless!
DHSwitch customer liaison officers are available to assist GPs to analyse the statistics and obtain optimum results. In addition, advanced training on electronic data interchange (EDI) technology and its benefits is available.
GPs wishing to take advantage of, or learn more about, eCP can contact the DHSwitch Customers Services department on our toll-free number, 0800 111 703, or visit our Web site at www.dhsolutions.co.za.
We look forward to continuing to partner you in the drive towards enabling better practice management.
Share
Editorial contacts