Integrated Care Bundles, from encounter to authorized reimbursement
For hospitals, polyclinics, and healthcare networks executing bundled specialist care programs: the platform detects bundle opportunities in clinical output and orchestrates the process through authorization.
- Cardiology Care Bundle4 proceduresAuthorized
- Ophthalmology Bundle3 proceduresSubmitted
- Orthopedic Care Bundle5 proceduresBundle identified
How automated care bundling works in practice
From doctor order to claim authorization, with complete audit visibility.
- 01
Data captured at point of care
Consultations, diagnostic tests, and procedures are documented in regular clinical flow. Nobody re-types care records.
- 02
Automated bundle identification
Clinical output across recent billing cycles is scanned against bundle rules, and viable care packages appear for billing review.
- 03
Auditor approval & claim compilation
Upon biller confirmation, bundle claims are compiled automatically with all mandatory attributes and diagnosis coding.
- 04
Electronic authorization exchange
Standardized XML submission files generate in compliance with regulatory authorization systems.
- 05
Automated response processing
Authorization files are imported and verified voucher numbers link automatically to the corresponding patient encounter.
- 06
Zero duplicate billing
Procedures bundled into the comprehensive package are automatically removed from unbundled fee-for-service instruments.
Rules checked before submission
The engine validates each procedure against clinical guidelines, patient eligibility, and fee criteria, preventing rejection before filing.
- Care modality, complexity, and billing instrument verification
- Age bounds, price schedule, and specialty requirements
- Recommended ICD diagnosis codes and clinical credentials
- Conditioned medical order rules by procedure
- Single encounter episode packaging without overlap
- Elective care encounter classification
- Authorized discharge disposition codes for bundled care
- Reconciliation between imported lab reports and generated claims
- 130-minute discovery
We analyze your departments, current systems, and clinical bottlenecks.
- 2Tailored live demo
The real workflow of your hospital, from patient reception to billing.
- 3Deployment roadmap
Modules, phased rollout plan, and timelines tailored to your facility.