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INFINITT Financial Portal

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Revolutionising Radiology Billing: The INFINITT Financial Portal Integration

After integrating the INFINITT RIS system with multiple South African Billing companies, Continuum system realised that the technology being used for financial, collections and billing systems for Radiology was totally inadequate for the businesses it was servicing.

In 2017 Continuum Systems and INFINITT Healthcare started to develop the financial portal into the single database INFINITT RIS PACS system.

After 4 years of design and development the product was ready for market. 2021 saw the start of the rollout process and by the end of 2022 all sites had been moved from the Mastermed billing system to the INFINITT financial portal. Record collection rates and staff efficiencies were immediately recognised as the INFINITT financial portal became the platinum standard for Radiology financial and billing systems in South Africa.

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How was this achieved?

To develop a truly integrated, efficient system for radiology practices, Continuum Systems and INFINITT Healthcare implemented a series of cutting-edge features designed to streamline every aspect of data capture, patient and billing management, and workflow automation. This unified approach ensures accurate data entry, automated validations, and direct integration with third-party services, optimising processes and reducing bottlenecks. By focusing on both automation and user-centric enhancements, the INFINITT RIS PACS system has transformed radiology financial operations, delivering a seamless experience for both healthcare providers and patients.

Controlling the RIS, patient and billing information capture

Being a single system where the RIS and the financial billing system are in the same system with no integration it was important to control the quality of data capture upfront rather than rely on this information to be corrected later on in the financial billing system.

  • SA ID authentication prevents duplicate patient / guarantor creation
  • Automated membership checks validate patient and member details and validity of scheme membership – resulting in the industries lowest rejection rates
  • Upfront account status warnings
  • Fast accurate capture including postal code and suburb lookup
  • Complete digital workflow for scheme authorisations with status management
  • Dedicated capture fields depending on the payment type selected with no repurpose of fields
    • Scheme
    • Private
    • Company
    • WCA
  • Easy instant quotation process based on scheme and procedure
  • Rules based data validation to ensure data is accurate before automatic invoicing and submissions
  • Financial processes available directly in the RIS based on user rights
    • Quotations
    • Receipting, supporting multiple visits across multiple payment methods
    • Invoicing
    • Cashups by department / user with approval process if required and direct to bank deposit slip
    • Account status checks with bad debt alerts
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Automation

Understanding the volume of patients and studies that move through a busy Radiology department, was a driving issue to implement system automation over manual labour to increase accuracy as well as reduce staffing costs.

With automation setup via a simple user interface new rules for automation are setup and tested instantly without needing system development.

Automation of daily processes using system rules and AI logic:

  • ICD10 coding
  • Invoicing and submissions
  • Rejection responses from line level to group level to speed up the correction / resubmission process
  • Paper claims with scheme rules on required format
  • ERA receipting
  • WCA document uploads via FTP
  • Weekly scheme and consumable pricing updates
  • Collections exception based workbook presentation
  • Communications via SMS, Email or WhatsApp
    • Fully automated collection process communications via predefined templates
  • Journal automation based on complex rule sets with approval process if required
  • Workflow automation by changing the status of financial processes based on an additional time criteria
  • Handover process

Automated distribution of work

With the INFINITT single system, distributing and sharing load across multiple staff members and functions is important to ensuring equality within job functions and reducing the possibilities of a bottleneck.

auto assign

Types of user functions that the system will auto assign to:

    • Invoicing (the work that is not auto invoiced)
    • Authorisation users based on
      • Department
      • Logged in authorisation users
      • Authorisation status
      • Current daily load
    • Collections Clerks
    • Handover Clerks
    • Patient Liable Clerks
    • Submission clerks

Master Data Management

Being a single RIS and financial billing system has a major advantage of having a single source of master data within the system that does not rely on keeping 2 different databases in sync.

Master data is the core data within the system that users select when adding a new patient or visit or selecting the correct active scheme and plan.

Master data within the system that is available and updates in both RIS, PACS and financial billing includes

  • Schemes
  • Consumables
  • Pricing
    • Tariff rates per payment type
    • Consumable pricing per payment type
  • ICD10 codes
  • Postal codes and suburbs
  • Modality procedures
  • RSSA tariff codes and custom codes
  • Referring Doctors
  • System Users
  • User rights and access control

Integrations

Whilst the INFINITT system, RIS, PACS and Financial portal (Billing) system has no internal integration and is in a single database there are some important integrations with 3rd party systems.

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Mediswitch

Understanding the patient and guarantor’s scheme and plan options is becoming more complex to manage with many different scheme options available to the public. Knowing what will be the scheme portion versus the patient portion is important in making sure the patient portion is correctly collected upfront to prevent unnecessary collection processes.

Direct, real time integration into Mediswitch gives the power of instantly connecting to medical schemes for:

    • Membership validations
      • Automatic creation of patient from schemes patient information with the membership check
      • Patient information
      • Main member information
      • Dependent code
      • Scheme plan information
    • Benefit check
      • Line item response on what the scheme will pay
    • Electronic claim submissions
    • Electronic claims responses with detailed rejection reasons
    • Resubmissions after corrections
    • Electronic Remittance for automatic receipting
    • Scheme supported above functionality
    • Electronic claims for WCA and Compsol
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Medprax

The complete INFINITT system is updated weekly automatically, to keep certain master data updated with the latest information.

This includes updates for:

  • Scheme listing and structures
    • Administrator
    • Plan
    • Option
    • Discontinued schemes
    • Change in administration
  • Radiology consumables
    • NAPPI codes
    • Descriptions
    • Units and quantities
    • Manufacturer
    • Schedule
    • Pack size
    • Volume
    • Consumable rates per scheme option
      • Percentage markup amount or fixed amount
      • Maximum markup amount
    • Consumable cost pricing used for the scheme pricing calculations
      • Can be manually overridden in system if required

System Workbooks

The philosophy within the INFINITT system is to always provide actionable worklists of what needs to be done. Controlling (and measuring) the work that the users need to complete on a daily basis is a key driver of staff and system efficiencies.

The unlimited system workbooks are user based and present the work that needs to be done by the user in the predefined priority of those tasks.

Each workbook is created through the user interface rather than needing custom development and can be assigned to users by central management.

manage workbooks

Main Features of the System Workbooks

  • Central creation and management

  • Distribute to users

  • Lock workbooks from user edits

    • Filter criteria of the workbook

    • Columns displayed to user

  • Force the completion of the current workbook before continuation to the next workbook

  • Force the order in which workbooks need to be completed

  • Monitor task completion from BI system dashboards

Receipting of payments

Efficient and accurate processing of onsite payments, along with the automatic uploading of large bulk ERAs from schemes, as well as company and workers’ compensation payments, are crucial for a streamlined collection process. This ensures a clear understanding of which accounts have been settled and which still require collection.

Onsite receipting

Simplifying the process of taking payments within the department while the patient is there has become a critical part of good collection policy due to the high number schemes and plans that offer partial or non-payment for procedures.

Electronic payment management

Electronic payment are payments that are automatically loaded into the system via a secure integration between INFINITT system and Mediswitch

  • Dedicated worklist for bulk payment management
  • Scheme payments are automatically loaded into the system from Mediswitch
    • Preprocessing with visit matching and rejection group linking (line level to visit level)
  • Payments automatically linked back to the correct scheme
  • Banked amount and date of payment validation from statement before processing
  • Approval process before committing if required
  • Fast processing of payment once approved
  • Visit will show a pending payment before ERA has been processed to show a pending payment coming in
  • Full history of all bulk payments with visit and line level detail of claim payments
  • Easy management of non linked visits
    • Post to suspense account
    • Match to visit later
  • Access visit information directly for fast corrections and resubmissions if required
 

Manual loading of bulk payments

Large payments made by companies, workman’s compensation, private payments from bank statements as well as schemes that do not support electronic remittance can easily be imported via a csv file for easy loading, tracking and reconciliation.

The INFINITT financial system supports line level csv files with rejection codes as well as a simpler visit level csv file depending on the level of detail provided by the payor.

  • Simple csv templates
  • Fast importing and processing within the system