| Chida | Intake.Dental | Pearl RCM |
|---|---|---|
| Cholinga chachikulu | Ndondomeko yonse ya ndalama: tsimikizira, vomereza zisanachitike, tumiza, tsatira, ika, tsutsa, phunzira | Kukonzekera kwa pempho asanachitike ulendo: kuyenerera, mapindu, kuyang'ana zolemba ndi mtundu wa ma-X-ray |
| Kumene kumakhala | Dashboard yake yomwe, kuwerenga kuchokera ndi kulemba kubwerera ku PMS | Wophatikizidwa mu ndondomeko ya PMS ndi khadi la kukonzekera |
| Kuyenerera | Kuyenerera kwa zamagetsi maola 48 asanachitike ulendo uliwonse, kukwezedwa ku mawu a AI pamene yankho la zamagetsi silikwanira | Kuyang'ana poyamba: kuyenerera kuchokera ku ma-clearinghouse anayi ndi ma-portal a zopereka zoposa 300, zomwe zikuwonetsedwa mu khadi la kukonzekera (malinga ndi Pearl) |
| Mapindu a mulingo wa ma-code | Sungiro la pa-CDT-code: kuphimbidwa %, malire a kuchuluka, nthawi yakudikirira, mbendera za chilolezo chisanachitike — zolemba kubwerera ku PMS | Mapindu a mulingo wa ma-code omwe akuwonetsedwa mu ndondomeko (malinga ndi Pearl) |
| Kutsimikizira kwa mawu | Wothandizira wa mawu a AI amalimbikitsa wolipira pamene kuyenerera kwa zamagetsi kulephera | Osafotokozedwa pa tsamba la RCM la Pearl lomwe lili poyera |
| Zovomerezeka zisanachitike | Mndandanda wa ntchito zosankhidwa, malamulo a pa-wolipira omwe aphunziridwa kuchokera ku zokanidwa, nkhani yomwe yakonzedwa pachati, kutsimikiza zisanachitike kwa zamagetsi ndi kusankha kowonekera, chenjezo la kutha | Siiperekedwa |
| Machenjezo a zikalata zisanachitike ulendo | Mlingo wa chiopsezo chokanidwa asanaitumize ndi njira yeniyeni yokonzera; malamulo okhudza zolumikizidwa pa kodi iliyonse | Claim Actions: machenjezo mu ndondomeko ya mipikisano yosowa kapena yakale ya X-ray, mavuto a ubwino, ndi mipata ya kukwaniritsa asanachitike ulendo |
| Ubwino wa X-ray pa nthawi yojambula | Siiperekedwa | Imagecheck imawonetsa zolakwika za ubwino wa X-ray pa nthawi yojambula |
| Kutumiza claim | Imapanga claim kuchokera ku njira zomaliza ndikuitumiza pa kulumikizana kwake kwa clearinghouse, kuphatikizapo zolemba zolumikizidwa ndi nkhani | PMS imatumiza claim |
| Kutsatira claim | Zovomerezeka za 277CA ndi malipiro a 835 ogwirizana ndi claim iliyonse; mafunso a 276/277 pa makhalemo okalamba | Sikunafotokozedwe pa tsamba la RCM la Pearl lopezeka poyera |
| Kulemba malipiro | 835 yolembedwa ku buku la ndalama, kuchepetsa mtengo wa mgwirizano kuchokera ku mitengo ya CAS ya wolipira, ma EOB a mapepala osanthula | Sikunafotokozedwe pa tsamba la RCM la Pearl lopezeka poyera |
| Kukana | Njira zokhazikitsidwa ndi CARC/RARC, kutsutsa kwa AI kuchokera mu tsamba, kutumizidwanso ngati claim yokonzedwa (pafupipafupi 7) | Kuyang'ana pa kuletsa: kukana kochepa chifukwa cha zikalata zisanachitike ulendo |
| Kudzilamulira | Gawo lililonse Kutseka / Kulangiza / Kuphunzira / Kudziyendetsa, pa chipatala chilichonse | Machenjezo ndi zidziwitso zowonetsedwa; ogwira ntchito amachita mu PMS |
| Kukwaniritsa kwa PMS | Kulumikizana mwachindunji ndi machitidwe akulu a mtambo kuphatikizapo mlatho wovomerezeka wophimba ena 60+ | Open Dental, Dentrix, Eaglesoft, Oryx, Curve, Denticon (monga Pearl) |
| Mitengo | Claims Intelligence $299.99/mwezi; Insurance Suite $399.99/mwezi; Kutsimikizira kokha $199.99/mwezi — zonse zolembedwa poyera | Sikunasindikizidwe pa tsamba la RCM la Pearl monga tinapeza; lumikizanani ndi Pearl |
Kuyenerera kwa zamagetsi kumayenda maola 48 asanachitike kukonzana kulikonse. Ngati yankho la zamagetsi la wolipira likusowa kapena losakwanira, wothandizira wa AI wa mawu amaimba wolipira ndikufunsa mafunso amene woyendetsa ndalama angafunse; zotsala zimapita ku mzere wa kuthetsa mavuto. Maubwino amasungidwa pa kodi ya CDT iliyonse — peresenti ya kukwaniritsa, malire a pafupipafupi, nthawi yodikira, mbendera zoloŵetsera zoyamba — ndipo zimalembedwa kubwerera ku PMS.
Precheck imakoka kuyenerera ndi zopindulitsa za ndondomeko kuchokera ku malo ogawanitsa anayi ndi zipata zoposa 300 za onyamulitsa ndipo imazionetsa mu khadi la nthawi yokomera, molingana ndi Pearl. Kukula kwa zipata ndi mwayi weniweni kwa olipira omwe amayankha bwino kudzera pa zipata kuposa momwe amathandizira pazogulitsana zamagetsi. Tsamba la Pearl palipagulu silimafotokoza njira ina yogwiritsira ntchito mawu.
Mndandanda wa ntchito ya chilolezo chisanachitidwe wosankhidwa molingana ndi tsiku lotsatira la odwala pampando, ndi malamulo pa munthu aliyense wolipira ophunzira kuchokera ku zikana za wolipirayu, nkhani ya kufunikira kwazachipatala yokonzedwa kuchokera mu fayilo, ndi chidziwitso choyambilira cha magetsi chomwe choyankha chibwera chokha. Nkhani iliyonse imalandira chiwongola dzanja cha chiwopsezo cha kukana ndi dzina lenileni la kukonza.
Claim Actions imakweza chenjezo m'nthawi ya ndondomeko pa zojambula za X-ray zomwe zilibe kapena zakale, mavuto a khalidwe, ndi mipata ya kuphimbidwa asanabwere kuchipatala, ndipo Imagecheck imadzudzula zolakwika za khalidwe la X-ray panthawi yojambula. Pearl imanena kuti izi zimabweretsa zochepetsa mpaka 80% pa zochepetsa ndondomeko ndi kukana komwe kuli ndi kufotokozera - chiwerengero cha Pearl yekha. Chilolezo chisanachitidwe si gawo la chinthucho.
Nkhaniyi imapangidwa kuchokera ku njira zomalizidwa mu PMS ndipo imatumizidwa pa kulumikizana kwa malo ogawanitsa a nsanja yomweyi ndi zolumikizira ndi nkhani. Zovomereza za 277CA ndi ndalama za 835 zimafananizidwa kubwerera ku nkhani iliyonse; nkhani zodekha zimalandira funso la chikhalidwe cha 276. Ndalama zimalembedwa ku buku ndi kuchotsedwa kwa mgwirizano kowerengedwa kuchokera ku kusintha kwa CAS ka wolipira, ndipo ma EOB a pepala amakoledwa kulowa m'njira yomweyo.
Ntchito ya Pearl RCM imatha pamene nkhani yoyera yachoka mu PMS. Kutumiza, kutsatira, ndi kulemba zimakhalabe ndi PMS ndi malo ogawanitsa omwe maphunzirowo akugwiritsa kale ntchito.
Kukana kulikonse kumagawidwa ndi ma code a CARC ndi RARC kukhala mndandanda wa zochita - kutseka zokha zobwereza, kulipiritsa wodwalayo, kulemba, kutumizanso kwakonzedwa, kupempha, kukweza. AI imalemba yankho kuchokera mu fayilo ndipo imatumizanso ngati nkhani yokonzedwa (kachiwiri 7) ndi nambala ya nkhani ya wolipira. Kuyesera kamodzi kokha, kenako ofesi imatumizidwa maimelo.
Njira ya Pearl ndi kuteteza: gwira vuto la kufotokozera asanabwere kuchipatala kuti kukana kusachitike. Kugwira ntchito pa kukana komwe kumafika kumakadali sikunafotokozedwe pa tsamba la Pearl RCM lapagulu.
Gawo lililonse ndi Lozimitsidwa, Kulangiza, Kufanizira, kapena Zokha pa maphunziro. Kutumiza kwa nkhani ndi chilolezo chisanachitidwe cha magetsi kumayamba Kuzimitsidwa kotero kuti palibe chobwerezera-malipiro pamene PMS ikukutumizabe. Kufanizira kumalemba zimene ikanaita kuti muthe kufanizira ndi gulu lanu musanasinthire kupita ku Zokha.
Pearl imaulutsa deta ndi machenjezo mkati mwa PMS; ogwira ntchito amazichita nawo pamenepo. Sichita zochita pa nkhani yomweyo.
Intake.Dental imalemba mitengo yake: Claims Intelligence (kutumiza, kutsatira, kulemba, kupempha, ndi kusanthula kwa wolipira) ndi $299.99/mwezi; Insurance Verification ndi $199.99/mwezi; Insurance Suite imawasunga onse pa $399.99/mwezi. Pearl saifalitsa mitengo ya RCM pa tsamba lake lapagulu monga momwe tingapeze, kotero chiwerengero chofanana n'chosatheka pano - funsa Pearl mtengo wake ndikufanizira ndi Suite. Zotsatira za Pearl - zochepetsa mpaka 80% pa zochepetsa ndondomeko ndi kukana komwe kuli ndi kufotokozera, kusunga mpaka maola 35 a ogwira ntchito pa sabata - ndi zonena za Pearl yomweyo; sitilengeza chiwerengero chofanana pa tsamba lino.
Palibe chinthu chomwe chimalowa m'malo mwa PMS, kotero palibe kusamutsa deta m'njira iliyonse. Kusuntha kuchokera ku Pearl RCM kupita ku Intake.Dental kumatanthauza kulumikiza PMS, kusiya gawo lililonse mu Kufanizira kwa sabata kuti mufananize mbiri yake ndi zimene gulu lanu lidachita, kenako kutsegula kutumiza ndi kuzimitsa kutumiza kwa PMS nthawi yomweyo kuti pakhale wotumiza mmodzi. Kusuntha njira ina kumatanthauza kusunga malo anu ogawanitsa apano ndi njira ya kukana ndikuwonjezera macha a Pearl asanachitike kuchipatala mkati mwa PMS.
Osati molingana ndi kufotokozera kwake kwapagulu. Pearl RCM imagwira ntchito pa nkhani asanachitike kuchipatala - kuyenerera, zopindulitsa za ndondomeko, kufotokozera ndi machenjezo a khalidwe la X-ray mkati mwa PMS - ndipo PMS imatumiza nkhani. Intake.Dental imatumiza pa kulumikizana kwake kokha kwa malo ogawanitsa ndipo imatsatira zovomereza ndi ndalama kubwerera ku nkhani iliyonse.
Chilolezo chisanachitidwe si gawo la kufotokozera kwapagulu kwa Pearl RCM. Intake.Dental imasunga mndandanda wa ntchito ya chilolezo chisanachitidwe wosankhidwa ndi tsiku la mpando, imakonza nkhani kuchokera mu fayilo, imatumiza chidziwitso choyambilira cha magetsi, ndipo imalumikiza nambala ya kuvomereza ku nkhani yomaliza.
Inde, ndipo kufanana ndi kochepa. Machenjezo a Pearl mkati mwa PMS ndi Imagecheck amagwira ntchito pa kuchipatala; Intake.Dental imagwira ntchito pa nkhani kuchokera pakutumiza patsogolo. Ngati mugwiritsa ntchito zonse ziwiri, siyani gawo la kutsimikizira la Intake.Dental Lozimitsidwa kapena mu Kufanizira kuti musapeze kutsimikizira kuyenerera kawiri pa wodwala yemweyo.
Malo atatu: imakhala mkati mwa khadi la nthawi yokomera la PMS osati chinsalu chachiwiri; imayang'ana khalidwe la X-ray panthawi yojambula, chomwe Intake.Dental sichita; ndipo kukula kwake kwa zipata - 300+ zipata za onyamulitsa - ndi kwakukulu kuposa njira yoyamba ya magetsi imafika yokha.
Ndi zonena za Pearl yomweyo kuchokera pa tsamba lake lapagulu - zochepetsa mpaka 80% pa zochepetsa ndondomeko ndi kukana komwe kuli ndi kufotokozera, ndi kusunga mpaka maola 35 a ogwira ntchito pa sabata. Sitinazitsimikizire ndipo sitifalitsa chiwerengero chopikisana.
Sankhani Pearl RCM ngati zimene mukufuna ndi nkhani yoyera yochoka mu PMS - kuyenerera ndi kufotokozera kwatsimikiziridwa mkati mwa ndondomeko, ma X-ray atsimikiziridwa pakujambula - ndipo PMS ndi malo ogawanitsa anu amagwira ntchito za ena bwino. Sankhani Intake.Dental ngati mukufuna zinazo zitagwiritsidwanso ntchito: kutsimikizira kwa mawu a AI pamene magetsi alephera, chilolezo chisanachitidwe, kutumiza ndi kutsatira kwa nkhani, kulemba ndalama, ndi kukana koyankha ngati nkhani zokonzedwa, gawo lililonse lomwe limayakidwa pokhapokha mukalola.
Pearl RCM imakhala mkati mwa dongosolo la kasamalidwe ka maudindo ndipo imagwira ntchito pa pempholi asanachitike ulendo: kuyenerera ndi mapindu a mulingo wa ma-code mu khadi la kukonzekera, chenjezo la ma-X-ray omwe akusowa ndi mipata ya kuphimbidwa, ndi kuyang'ana mtundu wa ma-X-ray pakujambula. Intake.Dental imayamba pamalo omwewo ndipo imapitirira — zovomerezeka zisanachitike, kutumiza mapemphero pa kulumikizana kwake kokha kwa clearinghouse, kutsatira kuvomereza ndi kubweza, kuika m'buku la ndalama, ndi zotsutsa zomwe zimatumizidwa ngati mapemphero omwe adasinthidwa. Zimagwirizana pa gawo loyamba ndipo zimasiyana pa chilichonse pambuyo pake.
Ikani chiwonetsero cha ola limodzi ndipo tidzakuonyesani momwe timafananira pa zinthu zomwe zili zofunika ku chipatala chanu.
Ngati mumagwiritsa kale ntchito Dentrix, ndi zimene Intake Dental imawonjezera ndi chifukwa chake simalowa m'malo mwa PMS yanu.
