| Fasali | Intake.Dental | Pearl RCM |
|---|---|---|
| Babban mayar da hankali | Cikakken zagayowar kudaden shiga: tabbatarwa, izini na gaba, ƙaddamarwa, bibiya, sanyawa, ƙararraki, koyo | Shirye-shiryen da'awa kafin ziyara: cancanta, fa'idodi, binciken takaddun shaida da ingancin hoton X-ray |
| Inda yake aiki | Dashboard nasa, yana karantawa daga kuma rubuta zuwa PMS | An haɗa shi a cikin jaddawalin PMS da katin alƙawari |
| Cancanta | Cancanta ta hanyar lantarki sa'o'i 48 kafin kowane ziyara, yana haɓaka zuwa kiran murya ta AI lokacin da amsar lantarki ba ta cika ba | Bincike na farko: cancanta daga gidajen share fage huɗu da ƙofofin ɗaukar hoto sama da 300, da aka nuna a cikin katin alƙawari (kamar yadda Pearl ta bayyana) |
| Fa'idodi masu dogaro da lambar | Ajiya ta kowace-lambar-CDT: kashi na ɗaukar hoto %, iyakokin yawan aiki, lokutan jira, alamun izini na gaba — an rubuta su zuwa PMS | Fa'idodi masu dogaro da lambar da aka nuna a cikin jadawalin (kamar yadda Pearl ta bayyana) |
| Tabbatar da murya | Wakili mai sauti na AI yana kiran mai biyan kuɗi lokacin da izinin lantarki ya kasa aiki | Ba a bayyana a shafin RCM na jama'a na Pearl ba |
| Izinin da aka gabatar kafin gwamnati | Jerin ayyuka da aka tsara, ƙa'idodin kowane mai biyan kuɗi da aka koyi daga ƙi, labarin da aka tsara daga taswirar likita, ƙudiri na lantarki tare da matsayi ta atomatik, faɗakarwar ƙarshen lokaci | Ba a bayar da shi ba |
| Faɗakarwar takaddun kafin ziyara | Maki na haɗarin ƙi kafin ƙaddamarwa tare da sunan gyara na musamman; ƙa'idodin abubuwan da aka haɗa ga kowane lambar | Ayyukan Da'awa: faɗakarwa a cikin jadawalin don ɓataccen ko tsohuwar hotunan X-ray, matsalolin inganci, da gibin ɗaukar nauyi kafin ziyara |
| Ingancin hotunan X-ray yayin ɗaukar hoto | Ba a bayar da shi ba | Imagecheck yana nuna lahani na ingancin hotunan X-ray yayin ɗaukar hoto |
| Ƙaddamar da da'awa | Yana gina da'awar daga hanyoyin da aka kammala kuma yana ƙaddamar da ita akan haɗin sa na cibiyar sharewa, tare da haɗaɗɗun takardun da labari | PMS yana ƙaddamar da da'awar |
| Bin diddigin da'awa | Sanarwar yarda ta 277CA da biyan kuɗi na 835 da aka haɗa zuwa kowace da'awa; tambayoyin matsayi na 276/277 akan da'awoyin da suka dade | Ba a bayyana a shafin RCM na jama'a na Pearl ba |
| Sanya biyan kuɗi | An sanya 835 a cikin littafin lissafi, rubuta ragewa na kwangila daga adadin CAS na mai biyan kuɗi, an haƙa takardun EOB | Ba a bayyana a shafin RCM na jama'a na Pearl ba |
| Ƙin yarda | Matakan aiki da aka rarraba ta CARC/RARC, ƙin yarda ta AI daga takardar jinya, an sake aikawa azaman da'awar da aka gyara (mitar 7) | Mayar da hankali kan rigakafi: ƙarancin ƙin yarda daga takaddun kafin ziyarar |
| Yancin zaɓi | Kowane mataki Kashe / Ba da shawara / Kwaikwayi / Atomatik, ga kowane aikin | Sanarwa da bayanan da aka gabatar; ma'aikata suna aiki a cikin PMS |
| Ɗaukar nauyin PMS | Haɗin kai kai tsaye tare da manyan tsarin gajimare ƙara da gada mai takaddun shaida wanda ya shafi fiye da 60 wasu | Open Dental, Dentrix, Eaglesoft, CareStack, Oryx, Curve, Denticon (bisa ga Pearl) |
| Farashin | Claims Intelligence $299.99/kowane wata; Insurance Suite $399.99/kowane wata; Tabbatarwa kaɗai $199.99/kowane wata — duk an jera su a bainar jama'a | Ba a buga shi a shafin RCM na Pearl kamar yadda muka gano; tuntuɓi Pearl |
Ana gudanar da binciken cancantar lantarki sa'o'i 48 kafin kowane alƙawari. Idan amsar lantarki ta mai biyan kuɗi ta ɓace ko ba ta cika ba, wakili mai murya na AI zai kira mai biyan kuɗi ya tambayi tambayoyin da mai lissafin kuɗi zai yi; sauran za su je layin magance matsaloli. Ana adana fa'idodi a kowace lambar CDT — kashi na ɗaukar nauyi, iyakokin yawan lokaci, lokutan jira, tutoci na izini na gaba — kuma a rubuta su zuwa PMS.
Precheck yana ɗaukar cancanta da fa'idodin matakin lambar daga wuraren share fage huɗu da fiye da shafukan masu ɗaukar nauyi 300 kuma yana nuna su a cikin katin alƙawari, a cewar Pearl. Wannan faɗin shafuka babban fa'ida ce ga masu biyan kuɗi waɗanda suke ba da amsa ta shafin fiye da ta ciniki na lantarki. Shafin jama'a na Pearl bai bayyana magani na murya ba.
Jerin ayyukan izini na gaba wanda aka tsara bisa ranar kujera ta gaba ta majiyyaci, tare da ƙa'idodin kowane mai biyan kuɗi da aka koya daga ƙin yarda na wannan mai biyan kuɗi, labarin larura na likita wanda aka tsara daga takardar tarihi, da ƙaddamarwar lantarki wanda matsayinsa ke dawowa ta atomatik. Kowane ikrari yana samun maki na haɗarin ƙin yarda tare da sunan gyaran takamaiman.
Claim Actions yana ɗaga faɗakarwar cikin jadawalin lokaci don ɓatattu ko tsoffin hotunan X-ray, matsalolin inganci, da gibin ɗaukar nauyi kafin ziyarar, kuma Imagecheck yana nuna lahanan ingancin hoton X-ray a lokacin ɗaukarsa. Pearl ta ce wannan yana haifar da rage downcodes da ƙin yarda masu alaƙa da takardun har zuwa 80% — adadi na Pearl da kanta. Izinin gaba ba wani ɓangare ne na samfurin ba.
Ana gina ikrari daga hanyoyin da aka kammala a cikin PMS kuma an ƙaddamar da shi akan haɗin wurin share fage na dandamalin da kayan haɗe da labari. Ana daidaita 277CA yarda da 835 biyan kuɗi zuwa kowane ikrari; ikrare masu shiru suna samun tambayar matsayi ta 276. Ana buga biyan kuɗi a littafin lissafi tare da lissafin rubuce-rubucen kwangila daga daidaitawar CAS na mai biyan kuɗi, kuma ana haƙa takardun EOB zuwa wannan hanya.
Aikin Pearl RCM yana ƙarewa lokacin da ikrari mai tsabta ya bar PMS. Ƙaddamarwa, sa ido, da aikawa suna kasancewa tare da PMS da wurin share fage da wurin aikin ya riga ya yi amfani da su.
Ana rarraba kowane ƙin yarda ta lambobin CARC da RARC zuwa matakala na aiki — rufe kwafi ta atomatik, biya majiyyaci, rubuta, sake ƙaddamar da gyara, ƙara, haɓaka. AI yana rubuta ƙaryar daga takardar tarihi kuma yana sake aikewa azaman ikrarin da aka gyara (mita 7) tare da lambar ikrarin mai biyan kuɗi. Gwaji guda ɗaya na atomatik, sannan a aika imel ga ofis.
Hanyar Pearl ita ce rigakafi: kama matsalar takardun kafin ziyarar don kada ƙin yarda ya faru. Ba a bayyana aiki akan ƙin yarda waɗanda har yanzu suka iso ba a shafin RCM na jama'a na Pearl.
Kowane mataki shine Kashe, Ba da shawarar, Kwaikwayo, ko Atomatik a kowane wurin aiki. Ƙaddamar da ikrari da izinin lantarki na gaba suna farawa da Kashe don kada wani abu ya biya sau biyu yayin da PMS har yanzu yana ƙaddamarwa. Kwaikwayo yana rubuta abin da zai yi don ku iya kwatanta shi da ƙungiyarku kafin ku canza zuwa Atomatik.
Pearl yana bayyana bayanai da faɗakarwa a cikin PMS; ma'aikata suna aiki a kansu a can. Ba ya ɗaukar matakai akan ikrarin da kansa.
Intake.Dental yana jera farashinsa: Claims Intelligence (ƙaddamarwa, sa ido, aikawa, ƙararraki, da nazarin masu biyan kuɗi) shine $299.99/wata; Insurance Verification shine $199.99/wata; Insurance Suite yana haɗa duka a $399.99/wata. Pearl ba ta buga farashin RCM a shafinta na jama'a kamar yadda muka iya samu ba, don haka lambar kwatancen ba ta yiwuwa a nan — ku tambayi Pearl don tantance ku kwatanta shi da Suite. Sakamakon da Pearl ta bayyana — rage downcodes da ƙin yarda masu alaƙa da takardun har zuwa 80%, ceton sa'o'in ma'aikata har zuwa 35 a mako — iƙirari ne na Pearl ita kanta; ba mu yin irin wannan iƙirarin kashi a wannan shafi ba.
Babu wanda ya maye gurbin PMS, don haka babu ƙaura na bayanai a kowane bangare. Motsawa daga Pearl RCM zuwa Intake.Dental yana nufin haɗa PMS, barin kowane mataki a cikin Kwaikwayo na mako guda don kwatanta rajistarsa da abin da ƙungiyarku ta yi, sannan kunna ƙaddamarwa da kashe ƙaddamarwar PMS a lokaci guda don a sami mai aikawa ɗaya. Motsawa ta wata hanya yana nufin kiyaye wurin share fage ɗinku na yanzu da tsarin ƙin yarda sannan ƙara binciken Pearl na kafin ziyara a cikin PMS.
Ba bisa ga bayanin jama'arsa ba. Pearl RCM yana aiki akan da'awar kafin ziyarar — cancantar, fa'idodi masu alaƙa da lambar, takardun shaida da faɗakarwar ingancin hoton X-ray a cikin PMS — kuma PMS yana ƙaddamar da da'awar. Intake.Dental yana ƙaddamarwa akan haɗin gidan watsa labarai nasa kuma yana bin diddigin amintattu da kuma kuɗin da aka mayar zuwa ga kowane da'awar.
Izini na gaba ba wani ɓangare ba ne na bayanin jama'ar Pearl RCM. Intake.Dental yana adana jerin ayyukan izini na gaba wanda aka jera bisa ga ranar kujera, yana tsara labarin daga cikin takardar, yana aika ƙaddamarwar lantarki, kuma yana haɗa lambar amincewa zuwa da'awar ta ƙarshe.
I, kuma haɗuwar ba ta da yawa ba. Faɗakarwar cikin-PMS na Pearl da Imagecheck suna aiki akan ziyarar; Intake.Dental yana aiki akan da'awar daga ƙaddamarwa zuwa gaba. Idan kuna gudanar da su biyu, bar matakin tabbatarwa na Intake.Dental a Kashe ko a cikin Simulate don guje wa tabbatarwar cancantar sau biyu akan majiyyaci guda.
Wurare uku: yana zaune a cikin katin alƙawari na PMS maimakon allo na biyu; yana bincika ingancin hoton X-ray a lokacin ɗaukar hoto, wanda Intake.Dental ba ya yi; kuma faɗin tashar labarinsa da aka bayyana — tasoshi sama da 300+ na masu ɗaukar nauyi — ya fi girman hanyar farko ta lantarki da kanta.
Iƙirarin Pearl ne daga shafin jama'arsa — har zuwa raguwa kashi 80% na rage-lambar da ƙin amincewa da ke da alaƙa da takardun shaida, da kuma adana har zuwa sa'o'i 35 na ma'aikata a kowace mako. Ba mu tabbatar da su ba kuma ba ma buga kaso mai fafatawa.
Zaɓi Pearl RCM idan abin da kuke buƙata shine da'awar da ta fi tsabta ta barin PMS — an tabbatar da cancantar da takardun shaida a cikin tsarin jadawalin, an tabbatar da hotunan X-ray a lokacin ɗaukar hoto — kuma PMS ɗinku da gidan watsa labarai sun riga suna gudanar da sauran ayyuka da kyau. Zaɓi Intake.Dental idan kuna son a gudanar da sauran ayyuka ma: tabbatarwa ta murya ta AI lokacin da na lantarki ya kasa, izini na gaba, ƙaddamar da da'awar da bibiyar, buga kuɗin da aka mayar, da amsa ƙin da aka gyara a matsayin da'awar gyara, kowane mataki ana kunna shi ne kawai lokacin da kuka faɗa.
Pearl RCM yana aiki a cikin tsarin gudanar da ayyuka kuma yana aiki akan da'awa kafin ziyara: cancanta da fa'idodi masu dogaro da lambar a cikin katin alƙawari, sanarwa game da rasa hoton X-ray da gibin ɗaukar hoto, da binciken ingancin hoton X-ray yayin ɗaukar hoto. Intake.Dental yana farawa daga wurin guda kuma yana ci gaba — izini na gaba, ƙaddamar da da'awa akan haɗin gidan share fage nasa, bibiyar amincewa da biyan kuɗi, sanya lissafi, da ƙararraki da aka aiko a matsayin da'awar da aka gyara. Suna haɗuwa a matakin farko kuma suna rarrabuwa akan duk abin da ya biyo baya.
Yi ajiyar nuni na mintuna 30 kuma za mu nuna muku ainihin yadda muke kwatantawa akan fasalolin da suka dace da aikin ku.
Idan kuna riga kuna amfani da Dentrix, ga abin da Intake Dental ke ƙarawa kuma dalilin da ya sa ba ya maye gurbin PMS ɗin ku.
