Practice operations
Opselia reads the post, files what it can, watches the money, and raises the work that needs a person. It holds no patient data, and that is a property of how it is built rather than a promise in a document.
One denied claim, in two places
Read left to right
| Where | Patient | Date of birth | Member ID | Claim number | Code | Reason | Amount |
|---|---|---|---|---|---|---|---|
| In your system | ROWLAND, J | 1951-04-02 | XQ8841027 | 2204417 | 92014 | CARC 29 | 412.00 |
| In Opselia | ROWLAND, J | 1951-04-02 | XQ8841027 | WL-A1B2C3D4 | 92014 | CARC 29 | 412.00 |
The struck columns never leave your building. The claim number is replaced by a label that means nothing anywhere else, and the translation back to the real number stays on one computer in your office. What Opselia works with is the last three columns, which is all it needs to tell you that this payer has refused the same code eleven times.
What it does
Invoices become bills. Certificates get filed against the person they belong to. A reply that answers an open question closes it.
Which payer pays what against Medicare, which refusals keep repeating, and the bill that normally arrives by now and has not.
Findings become tasks with the list and the how, ranked by what it costs to leave them. They withdraw themselves when the gap closes.
Every unattended action is written down against the hour it happened, and shown to you the next time you open it.
The boundary
Not policy. There is no field for these, no import that accepts them, and the reads that could reach them are refused before a request is built.