Paladin Consultants, LLC

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Medical Billing Software

We were hired by a small company in northern NJ back in 1995, who had a business doing medical billing for a few ambulatory surgery centers, their doctors, and anesthesiologists.  At the time they were using a small Paradox database originally designed for Windows 3.1.  The system was inadequate for their business the, which was grossing a little less than $2 million a year.


There were poor controls on the system, - surgeries logged without patients, patients without surgeries, surgeries without doctors, and the like.
We migrated the existing records to an Industrial strength SQL Database, and designed a convenient front-end system for entering new data, and viewing and evaluating old data.  We created tools for listing cases by insurance carrier, so that operations calling one insurance company, could discuss all open cases with that company, regardless of at which center it was performed.    That made for fewer calls, and less time on hold.  Many more management tools were added:

 

  • Evaluation of payments by insurer,
  • Aging of receivables by center, insurer, by case type
  • Center by Center cost comparison
  • Electronic billing of insurance company
  • Measurement of productivity by physician
  • Complete financial detail by patient, and by case, just to name a few.
All the while this was going on, the insurance industry and the government was changing standards several times a year.  We kept up with these changes because the system was designed using modular architecture.  When changes came about either in reporting, or billing, we addressed the problem by modifying  the  self-contained procedures in the appropriate module.
That billing company, running our software, is now the largest in the state of NJ, and one of the largest in the country.
 
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