Web Development for DRG Claims Management
DRG Claims Management enables automated checks of treatment procedures.
- Duration 2012 – 2014
- Team 5 members
- Type Platform development
- Industry HealthTech
- Platforms Web
Project idea
The startup saw a competitive edge in helping insurance companies identify errors associated with patient treatment. The software detects inconsistencies that might have been made while adding codes to diagnoses and procedures.
Target audience
Insurance companies specializing in cooperation with healthcare institutions can use the project to optimize audits. The software helps detect such problems as carelessness, abuse, or waste of resources.
Results
IT Craft’s dedicated team delivered a custom cloud solution. Using SSIS packages, insurance providers import claims from any location. The results are verified and agreed with a healthcare provider.
-
.NET
-
C#
-
ASP.NET MVC
-
MS SQL
Project challenges
-
The team designed a flexible project architecture to ensure cost-effective changes in the codebase once the client improves its processes.The team helped the client implement a simple, straightforward UX for the service.
-
IT Craft engineers implemented a custom algorithm and tuned it based on the client's requirements.The system required enhanced security for HIPAA compliance. The team focused on extra protection for user documents and accounts.
Planning
Input
The client initially had:
- Vast experience in audit and billing processes.
- Awareness of end users’ pains and expectations.
- Project vision.
Analysis
The team:
- Focused on project requirements.
- Developed a custom algorithm.
- Enhanced project security.
Result
Our work resulted in:
- Timely project delivery.
- Positive client feedback on the team's performance.
- Growing popularity of the service.
Business benefits
Risk-free use
The vendor only takes a percentage of reimbursements.
User friendliness
Users only upload medical documents. The vendor checks the full compliance.
Streamlined processes
Once all errors are corrected, doctors can send requests to the healthcare company and negotiate treatment costs.
Optimization
The service detects claims with the most likely recoveries.
Main project features
User account & Automation algorithms
Users receive an account in the system upon approval. They upload documents, manage claims, and check statuses and reports.
A custom-built algorithm accelerates documentation review and validation of assigned treatment codes.
Appeal proof
DRG claim management team obtains an assigned agreement from a healthcare provider on audit findings, simplifying negotiations on cost adjustment.
Let’s figure out the best roadmap for your project.
Are you looking to validate your idea?
Project timeline
-
Project timeline
2012 – 2014
Technologies
-
ASP.NET MVC
-
3.0.NET Framework
-
C#
-
4.0Linq to SQL
-
SSIS
-
JQuery
-
MS SQL 2012
-
IIS 7