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Practice Management System

Lenasia Computer Services (LCS), a bureau that initially managed accounts for 55 (fifty-five) medical practices mainly General Practitioners, Dentists and Anesthetists, approached RapidSoft in February 1999 with a project. The objective of which initially was to convert from old Dbase system to a state-of-the-art windows based solution, and replacing the old QEDI interface with the EDIfact format interface through FirstNet.

The first phase commenced in February 1999. In June 1999, the new system was successfully implemented, and full training was provided to the data capturing staff and data administrator. In the next phase, QEDI interface was successfully replaced by EDIfact format FirstNet switch interface. Introduction of the new interface to MedPrax's Medicine, Injection and Materials database, significantly tightened up the validation. It also allowed for vast improvements from the previous functionality, creating an effective, successful user-friendly environment.

Some of the key features of the system are:

  • Logging of each patients' visits, diagnosis, treatment, medication etc. >
  • Matching the payments from the Remittance advice to the invoices.
  • Interfaces with MEDPRAX for NAPPI codes and latest Medicine and Consumables prices
  • Interfaces with various Medical Aid Schemes (e.g. MedScheme, Discovery Health, BankMed, Old Mutual etc.) transmitting Claims Data through Data switches such as FIRSTNET, MEDISWITCH, MX Health and Cape Medical Plan, QEDI etc
  • Complete Transmission Log Maintained
  • Statistics by Doctor / Medicine / Treatment
  • Windows-Based
  • Network Compliant

The nature of LCS business has been changing and expanding significantly since 2000 and RapidSoft has enthusiastically met every challenge. Thus ensuring that their system remained on par with their evolving business. LCS has constantly been exploring the possibility of interfacing directly with the various Medical Aid Administrators in order to speed up the turn around time on settling of the Medical Aid claims. So far LCS has established direct links with approximately 20 (twenty) different Administrators and RapidSoft has provided the respective interfaces to LCS.

The Medical Aid industry has generally been tightening up procedures in order to clamp down on fraudulent claims, to this end they have adopted several international standards. LCS commissioned RapidSoft to enhance the system to cater for these standards. For example, in 2002 ICD Codes were introduced, these are the International codes for Detail Diagnosis of patients. It is becoming compulsory for all the Practitioners to provide the relevant ICD code on each claim. The capturing of data at LCS and the validation in the system is of such a high standard that LCS has extremely good reputation in the industry for the quality of their data. Hence a large percentage of the claims submitted by LCS on behalf of their practices are settled promptly.

In 2002, the Orthodontist practices were introduced into the system. A further improvement to the system was made that facilitated for specialized dental work to be settled over a period of time, usually over a 24-month period.

Another important development that took place in 2002 was when Health Bridge (a Medical Aid administrator which handled approximately 1900 practices) approached LCS to facilitate the claim processing of Sizwe (another Medical Aid Administrator) data. RapidSoft achieved this by converting Health Bridge's Edifact format data to NSF format as required by Sizwe. This interface has been in operation for over a year. Since then several other Medical Aid Administrators has shown interest in LCS in order to transmit data on their behalf to various Medical Aids. Currently, we are testing the interface with Habit Solutions who administer data for several thousand Practices.

In October 2003, we introduced a query logging and follow-up module in to the system. Currently, LCS is negotiating with several Group Practices, and in the meantime RapidSoft is exploring the ways and means to introduce these Group Practices in to the system.

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