| Ibikoresho | Intake.Dental | Pearl RCM |
|---|---|---|
| Intego nyamukuru | Uruziga rwuzuye rw'amafaranga: kugenzura, kwemeza mbere, kohereza, gukurikirana, kohereza, kwihakirana, kwiga | Gutegurira ubwishingizi mbere y'usura: kuba mwemewe, inyungu, inyandiko n'igenzura ry'ubuziranenge bw'ifoto |
| Aho biherereye | Ikibaho cyabyo, gisoma kandi cyandika muri PMS | Byashyizwe muri gahunda ya PMS n'ikarita y'isabukuru |
| Kuba mwemewe | Kugenzura kuba mwemewe mu buryo bwa elegitoronike amasaha 48 mbere ya buri sura, kujya ku guhamagara kwa AI iyo igisubizo cya elegitoronike kidahagije | Kugenzura mbere: kuba mwemewe kuva kuri clearinghouse enye hamwe n'amasoko 300+ y'ubwishingizi, byerekanwa mu ikarita y'isabukuru (nk'uko Pearl ibivuga) |
| Inyungu ku rwego rwa kode | Ububiko bwa buri kode ya CDT: ijanisha ryo gupfukwa %, imipaka y'inshuro, igihe cyo gutegereza, ibendera ryo kwemeza mbere — byanditswe muri PMS | Inyungu ku rwego rwa kode zerekanwa muri gahunda (nk'uko Pearl ibivuga) |
| Kugenzura n'ijwi | Umukozi wa AI uhamagara uwishyura iyo kugenzura kuba mwemewe mu buryo bwa elegitoronike bidashoboka | Nta kisobanuro kuri paji rusange ya RCM ya Pearl |
| Kwemeza mbere | Urutonde rw'akazi rufite urutonde, amategeko ya buri wishyura yizwe biturutse ku kwangwa, inkuru yateguwe mu bubiko, kwemeza mbere mu buryo bwa elegitoronike hamwe n'imiterere ikora yonyine, umuburo wo kurangira | Nta kibazo cyatanzwe |
| Umuburo w'inyandiko mbere y'usura | Amanota y'ibyago byo kwangwa mbere yo kohereza hamwe n'igisubizo cyihariye cyavuzwe; amategeko y'inyongera kuri buri kode | Ibikorwa by'ubwishingizi: umuburo mu gahunda w'ifoto zibura cyangwa zashaje, ibibazo by'ubuziranenge, n'inenge zo gupfukwa mbere y'usura |
| Ubuziranenge bw'ifoto igihe ifatwa | Nta kibazo cyatanzwe | Imagecheck iranga inenge z'ubuziranenge bw'ifoto igihe ifatwa |
| Kohereza ubwishingizi | Kubaka ubwishingizi buhereye ku bikorwa byarangiye no kubwohereza ku isano yayo ya clearinghouse, inyongera n'inkuru birabariyemo | PMS yohereza ubwishingizi |
| Gukurikirana ubwishingizi | Kwemeza 277CA n'imenyesha 835 byahujwe na buri bwishingizi; ibibazo bya 276/277 ku bwishingizi bwashaje | Nta kisobanuro kuri paji rusange ya RCM ya Pearl |
| Kohereza kwishyura | 835 yoherejwe kuri ledger, kwandika amasezerano kuva ku mafaranga ya CAS y'uwishyura ubwe, EOB z'impapuro zakoreshejwe | Nta kisobanuro kuri paji rusange ya RCM ya Pearl |
| Kwangwa | Uruziga rw'ibikorwa rwashyizwe mu byiciro na CARC/RARC, igisubizo cya AI kiva mu bubiko, cyongewe gicyoherezwa nk'ubwishingizi bwakosowe (inshuro 7) | Byibanda ku kurinda: kwangwa gake biturutse ku nyandiko mbere y'usura |
| Kwigenga | Buri cyiciro Bidakora / Kugira inama / Kugereraniriza / Ikora byonyine, kuri buri kibanza | Umuburo n'amakuru yerekanwe; abakozi bakora muri PMS |
| Gupfukwa na PMS | Guhuza mu buryo butaziguye na sisitemu nkuru z'ibicu hamwe n'ikiraro cyemewe gifite 60+ izindi | Open Dental, Dentrix, Eaglesoft, CareStack, Oryx, Curve, Denticon (nk'uko Pearl ibivuga) |
| Ibiciro | Claims Intelligence $299.99/ukwezi; Insurance Suite $399.99/ukwezi; Verification yonyine $199.99/ukwezi — byose byatangajwe ku mugaragaro | Ntibyatangajwe ku rupapuro rwa Pearl RCM nk'uko twagerageje gushakisha; muvugishe na Pearl |
Eligibility ya elegitoronike ikora amasaha 48 mbere y'isaburo ryose. Niba igisubizo cya elegitoronike cy'uwishyura kibura cyangwa kidahagije, agent y'ijwi ya AI ihamagara uwishyura isaba ibibazo uwubara yabaza; ibindi bigenda ku rutonde rw'ibikorwa ngenderwaho. Inyungu zibikwa kuri buri code ya CDT — amafaranga yishyurwa, imipaka y'inshuro, igihe cyo gutegereza, amabendera y'iyemeza rya mbere — kandi zandikwa muri PMS.
Precheck ikurura eligibility n'inyungu z'urwego rwa code ziva muri clearinghouse enye no mu maportail y'abashyura arenga 300 kandi ikabyerekana mu karito k'isaburo, nk'uko Pearl ibivuga. Ubwo bugari bwa portal ni inyungu nyayo ku bashyura basubiza neza kuri portal kuruta mu bikorwa bya elegitoronike. Urupapuro rusange rwa Pearl ntirwumvisha amajwi akurikira.
Urutonde rw'imirimo yo kwemeza mbere rushyizwe mu ishusho rukurikije itariki ikurikira y'umurwayi mu ntebe, hamwe n'amategeko kuri buri wishyura yigishijwe biva ku kwanga kwe, inkuru y'agakenerwa k'ubuvuzi iteganijwe ku karito, hamwe n'iyemerwa rya elegitoronike ryakwa imiterere yakirwa mu buryo bwikora. Buri kibazo kibona amanota y'ibyago byo kwangwa hamwe n'ikosora ryihariye ryitwaje izina.
Claim Actions izamura inguruguru zo mu gahunda k'ibishushanyo bya X-ray bibura cyangwa bishaje, ibibazo by'ubwiza, n'inzitizi mu ishyura mbere y'usura, kandi Imagecheck yerekana amakosa y'ubwiza bwa X-ray igihe yafatiwe. Pearl ivuga ko ibi biganisha ku kugabanuka kwa 80% mu kwanguza kw'amakode no kwangwa bifitanye isano n'inyandiko — ibibaro bya Pearl ubwabyo. Ibyemezo bya mbere ntabwo ari igice cy'ibicuruzwa.
Ikibazo cyubatswe biturutse ku bikorwa byarangiye muri PMS kandi cyoherezwa ku ihuza rya clearinghouse ry'urubuga ubwarwo hamwe n'ibyahujwe n'inkuru. Iyemererwa rya 277CA hamwe n'iyishyurwa rya 835 rihuza ku kibazo icyo ari cyo cyose; ibibazo bicecekeye bibona ikibazo cya 276. Kwishyura kwandikwa ku gitabo hamwe n'iyandikwa ry'amasezerano ribarwa biturutse ku mikoreshereze ya CAS y'uwishyura ubwe, kandi EOB z'impapuro zicukurwa muri iyo ntambwe.
Umurimo wa Pearl RCM urangira iyo ikibazo gisukuye gisohoka muri PMS. Kohereza, gukurikirana, no kwandika biguma muri PMS na clearinghouse ishinzwe gukora imirimo isanzwe.
Buri kwanga gushyirwa mu byiciro bikurikije kode za CARC na RARC mu ngazi y'ibikorwa — gufunga ku buryo bwikora impinduka, kwishyuza umurwayi, kwandika, kohereza byakosowe, guhakana, kuzamura. AI yandika kwemera biturutse ku karito hanyuma yongera kohereza nk'ikibazo cyakosowe (inshuro 7) hamwe na numero y'ikibazo cy'uwishyura. Umuntu umwe ukoresha mu buryo bwikora, hanyuma ubiro bwemerezwa imeri.
Uburyo bwa Pearl ni ukwirinda: kwifata ibibazo by'inyandiko mbere y'usura kugira ngo kwangwa kutabaho. Gukora ku kwangwa gukomeza kugera ntabwo byasobanuwe ku rupapuro rusange rwa Pearl RCM.
Buri cyiciro ni Off, Recommend, Simulate, cyangwa Auto kuri buri kibanza. Kohereza ibibazo n'ibyemezo bya elegitoronike bya mbere bitangira Off kugira ngo ntakindi kibaze kabiri mu gihe PMS ikomeje kohereza. Simulate irandika icyo yaba yakoreye kugira ngo mubishyireho ku muryango wanyu mbere yo guhindura kuri Auto.
Pearl itanga amakuru n'inguruguru imbere muri PMS; abakozi bakora kuri byo hariya. Ntabwo bifata ibikorwa ku kibazo ubwacyo.
Intake.Dental itanga ibiciro byayo: Claims Intelligence (kohereza, gukurikirana, kwandika, kwakira, hamwe n'isesengura ry'uwishyura) ni $299.99/ukwezi; Insurance Verification ni $199.99/ukwezi; Insurance Suite ihuza byombi kuri $399.99/ukwezi. Pearl ntitanga ibiciro bya RCM ku rupapuro rwayo rusange nk'uko twagerageje gushakisha, bityo umubare wo kugereranya ntabwo ushoboka hano — musabe Pearl igiciro hanyuma mugereranyeho na Suite. Ibisubizo bya Pearl bivugwa — kugabanuka kwa 80% mu kwanguza kw'amakode no kwangwa bifitanye isano n'inyandiko, kugunga amasaha 35 y'abakozi ku cyumweru — ni ibyemeza bya Pearl ubwabyo; nta kivugo cy'ijanisha dukora kuri uru rupapuro.
Nta gicuruzwa gisimbuza PMS, bityo nta kwimukira amakuru mu cyerekezo icyo ari cyo cyose. Kwimuka uhereye kuri Pearl RCM ujya kuri Intake.Dental bivuze guhuza PMS, gusiga buri cyiciro muri Simulate icyumweru kimwe kugira ngo ugereranyeho irondoka ry'akazi abakozi bawe bakoze, hanyuma ukurura kohereza hanyuma uhagarika kohereza kwa PMS icyarimwe kugira ngo hari uwoherereza umwe. Kwimuka mu cyerekezo kindi bivuze kubika clearinghouse yawe n'inzira yo gukemura kwangwa hanyuma wongeraho kugenzura kwa Pearl kwa mbere y'usura imbere muri PMS.
Ntabwo ari byo nk'uko ibisobanuro byayo rusange bivuga. Pearl RCM ikora ku kibazo mbere y'usura — eligibility, inyungu z'urwego rwa code, inguruguru z'inyandiko n'ubwiza bwa X-ray imbere muri PMS — kandi PMS yohereza ikibazo. Intake.Dental yohereza ku ihuza ryayo rya clearinghouse kandi ikurikirana iyemererwa n'iyishyurwa bisubira ku kibazo icyo ari cyo cyose.
Ibyemezo bya mbere ntabwo ari igice cy'ibisobanuro rusange bya Pearl RCM. Intake.Dental ibika urutonde rw'imirimo yo kwemeza mbere rushyizwe mu ishusho rukurikije itariki y'intebe, yandika inkuru iturutse ku karito, yohereza iyemerwa rya elegitoronike ryakwa, kandi ihujwe na numero yemewe ku kibazo cya nyuma.
Yego, kandi ahantu bihurira ni hato. Inguruguru za Pearl mu PMS hamwe na Imagecheck bikora ku sura; Intake.Dental ikora ku kibazo kuva kohereza ugende. Niba ukoresha byombi, siga icyiciro cya kugenzura cya Intake.Dental muri Off cyangwa muri Simulate kugira ngo wirinde kugenzura eligibility kabiri ku murwayi umwe.
Ahantu hatatu: ibana imbere mu karito k'isaburo muri PMS aho kuba ecran rya kabiri; igenzura ubwiza bwa X-ray igihe yafatiwe, icyo Intake.Dental idakora; kandi ubugari bwa portal bwavuzwe — portal z'abashyura 300+ — ni bugari kuruta uburyo bwibanze kuri elegitoronike bwo bubona bwenyine.
Ni ibyavuzwe na Pearl ubwayo ku rupapuro rwayo rusange — kugeza kuri 80% y'iyimanika ry'amakuru n'ihakana ry'ibyangombwa bijyanye n'inyandiko, n'amasaha 35 y'abakozi yakizwe mu cyumweru. Ntabwo twabisubirijemo kandi ntitugaragaza ijanisha ritandukanye.
Hitamo Pearl RCM niba icyo ukeneye ari ikibazo cyeza gisohoka muri PMS — kwemeza uburenganzira n'inyandiko byakurikiranyweho mu gahunda, ifoto za X-ray zikurikiranwa mu gihe gifatwa — kandi PMS yawe n'ikigo cy'isohorerwa bisanzwe bikora ibindi byose neza. Hitamo Intake.Dental niba ushaka ibindi byose bikurikiranweho kandi: kwemeza kw'ijwi rya AI iyo uburyo bwa elegitoronike bunanirwa, kwemeza mbere, gutanga ibyangombwa n'ikurikirana, gushyira uburyo bwo kwishyura, no gusubiza ihakana nk'ibyangombwa byakosowe, buri cyiciro cyakwa gusa iyo wabivuze.
Pearl RCM iba imbere muri sisitemu y'imicungire y'ikigo kandi ikora ku serivisi mbere y'usura: kwemera n'inyungu ku rwego rwa code mu karita k'isabukuru, itangazo ku mashusho ya X-ray abuze n'inenge zo gupfunyikira, no kugenzura ubwiza bwa X-ray mugihe cyo gufata. Intake.Dental itangira ahantu hamwe kandi ikomeza — kwemeza mbere, kohereza serivisi ku ihuza ryayo rya clearinghouse, gukurikirana kwemera no kwishyura, gushyira ku gitabo, no kwihakana byoherejwe nk'ibibanza byakosowe. Bihuza ku ntambwe ya mbere kandi bitandukana ku bintu byose bikurikira.
Tegura icyerekezo cy’isaha imwe kandi tuzakwerekana neza uko tugereranya ku bidahinduka bikomeye ku kigo cyawe.
Niba umaze gukoresha Dentrix, hano hari icyo Intake Dental yongera kandi impamvu itasimbuza PMS yawe.
