Case Study (MCO)

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Nature of Customer Business: Primeiro Health Care(Hongkong and Macau)
Description: Primeiro Health Care collaborated with Magicsoft Asia Systems Pte Ltd to deploy Vanda MCO for 23 panel doctors and its 3 clinics.
Geographical location: Hong Kong and Macau
# of Clinics: 53
# of Doctors: 1
# of Therapists: >70
Type of server deployed: Windows Server
Vanda Modules:
  • Administrative Modules
    • Master data management
    • User Role and User Management
    • Service Commission
    • User Commission
    • Audit Trail
  • Aesthetics Management Modules
    • Customer Management Module
    • Calendar & Appointment
    • Digital Case Notes
    • Billing & Payment Module
    • Dispensing
    • Consent Form
    • Packages
    • Inventory
  • Reports and Claim Modules
    • Common Labels
    • Statistic Reports
    • Operational Reports
    • Claim submission
    • Claim approval and rejection
    • Claim report

Background

 

  • Workflow overview

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  • Scenario:

Primeiro has a contract with Hotel Lisboa(Casino&Hotel). Primeiro provides medical service for employee of Hotel Lisboa. John is an employee of Hotel Lisboa. The database is hosted at Primeiro HongKong server.

On 1-8-14, John went to clinic XXX, one of the 70 Panel doctors. Doctor of clinic XXX checked the details of John by accessing the CRM system firstly. After the medical service to John, doctor recorded the service detail. At the end of Aug, clinic XXX will send all the bills to Primeiro and claim the payment. At the same time, Primeiro will record the service detail for every transaction then process the payment to Clinic XXX.

For the other three clinics, which are owned by Primeiro, they used the same system and provided the same service to the employee of these contracted hotel. They also provide medical service to public.

Introduction of Vanda MCO

MCO stands for Managed Care Organization.

It is an umbrella term to define a health plan by setting a predetermined monthly fee and coordinate care through a defined network of physicians and hospitals.

Eg. You have an administrative entity, INSURANCE A (classify as MCO) linked with Company B (classify as company panel) to provide Patient John a predetermined/subsidized rate when visiting Clinic C.

Currently, Panel doctor record medical service details for each patient then sent bills to Primeiro every month. Primeiro need to record the same information after receiving the bills.

By using Vanda MCO, panel doctor update information to the system. Primeiro can prevent double entry works and check real-time information.

Vanda MCO allow the panel doctor update the patient records, track their bills and check patients’ information (Only see their patients).

Benefits of Vanda MCO

  • Productivity

Currently, Panel doctor record medical service details for each patient then sent bills to Primeiro every month. Primeiro need to record the same information after receiving the bills.

By using Vanda MCO, panel doctor update information to the system. Primeiro can get rid of double entry works and check real-time information.

Vanda MCO allow the panel doctor update the patient records, track their bills and check patients’ information (Only see their patients).

  • Accuracy

By using Vanda MCO, Primeiro can avoid the human errors.

  • Data security and control

The characteristic of Vanda MCO, desktop based, can help to protect our data compared with current CRM system, web based.

Primeiro can manage i.e. monitor and cross check all claims payment status. Vanda MCO require one unique license for every PC.

Primeiro can view consolidated reports for all panel doctors and access to all panel doctors’ data.