End-to-End Revenue Cycle Management Services in Australia

It is a Healthcare platform that deals with various aspects of patient data. Power BI application provides a patient dashboard and various metrics related to namely hypertension, diabetes, colon cancer, etc. These metrics are calculated by giving start dates and end date parameters. Dax measures are used to formulate the logic behind the measures. The platform is a POWER BI reporting tool on top of consolidating the FHIR standards database. All the Databases & Reports are hosted on the Azure Cloud platform

The primary objective of the platform is to transform the neuro clinic’s data into an intelligent, and research-enabling asset by implementing a Clinical Decision Support and Research System (CDSS) that consolidates patient, operational, and financial information into one secure, analytics-driven environment. The solution provides real-time insights for clinical decision-making, research enablement, and revenue visibility, ensuring HIPAA-compliant data governance. It will also streamline operational workflows by automating performance tracking, monitoring patient flow, and improving scheduling efficiency, while strengthening financial management through comprehensive visibility into revenue, billing accuracy, and payer mix analysis. 

The objective is to develop a separate Claims management system for automating insurance eligibility verification, claims creation, scrubbing, submission, claims remittance and denial management using EDIs. They have a EMR with the patient data, and need a solution to help empower their business performance, productivity and compliance initiatives. they need:
Claims Management: Speed and ease claims and remittance processing with electronic claims submission powered by an extensive connectivity network.
Eligibility Verification: Determine patient coverage at any time in the revenue cycle to help improve the patient experience and reduce claim denials.
Claim Status: Improve claim visibility during payer processing with claim status from EDI transactions and payer portals.

The AI-driven reporting and analytics solution integrates with eClinicalWorks (eCW) to enhance healthcare data extraction, automate compliance reporting, and improve patient outcomes through predictive analytics. This initiative leverages AI, NLP, and SMART on FHIR to streamline workflows, reduce manual effort, and ensure real-time data accessibility.  

We are developing a comprehensive, NDIS-compliant CRM platform for allied health service provider in Australia, focused on supporting children and young people with disabilities through therapies such as Occupational Therapy, Speech Therapy, Psychology, Physiotherapy, Counselling, and Behaviour Support.

The platform streamlines end-to-end operations including client onboarding, service agreement management, therapist workflows, session scheduling, case notes, and compliance-driven billing. It enables accurate NDIS service code mapping, automated invoicing aligned with different funding types (Self, Plan, and NDIA-managed), and real-time budget tracking to prevent over-claiming and reduce payment errors.