Overview
Aptly named, MediBetter was created to address significant challenges faced by Australian General Practitioners (GPs) and clinics surrounding medical billing compliance and efficiency. MediBetter’s vision is to improve the financial viability and sustainability of General Practice to ensure primary healthcare is affordable and accessible for all Australians. The Intergy team was engaged by the business as a specialised technology provider, to help realise MediBetter’s vision and create the underlying AI-powered platform.
The Challenge
The Medicare Benefits Schedule (MBS), the primary source of income for GPs and their clinics, is a complex, time-consuming system that is difficult to navigate and interpret. These difficulties lead to suboptimal and often incorrect billing, which can result in hefty fines for the GP and increased administrative work. In an effort to avoid audits, GPs are underutilising the MBS which leads to missed billing opportunities and reduced consultation revenue. Many GPs and clinics are increasing private fees and out-of-pocket costs for patients to make up for this missed revenue, which is impacting on affordability and accessibility to primary healthcare for Australians.
The Solution : MediBetter
MediBetter is a cutting-edge AI-powered recommendation engine that optimises and streamlines MBS billing processes for GPs by providing potential MBS billing item codes and guidance surrounding compliance. The application aims to:
- Optimise revenue for GPs and their clinics while reducing out-of-pocket costs for patients.
- Enhance MBS billing compliance through improved accuracy.
- Reduce time that GPs are spending on billing to ensure they are able to focus their time and energy on their patients.
Key Features
AI Recommendation Engine
Continuous Expert Training
AI Chatbot
User-Friendly Interface
Technical Details
- Microsoft Azure Cloud: Hosts the web app and SQL database.
- Azure OpenAI and Cognitive Search: Power the AI functionalities.
- Data Pipelines, Embedding Model, and Prompt Module: Enhance data processing and AI training.
- Machine Learning and Fine Tuning: Ensure the AI model continuously improves with expert feedback.
How MediBetter Works – Step by Step
1
Recommendation Filtering
The AI filters recommended MBS item numbers based on patient consultations.
2
Item Number Selection
GPs select relevant item numbers from the AI’s recommendations.
3
Search Functionality
GPs can search for specific item numbers or descriptions.
4
Compliance Warnings
Alerts for any co-billing restrictions.
5
Approval Process
Final item numbers and consultation notes are reviewed by experts before training the AI model.
6
Implementation
Real-world implementation of these steps, leading to further machine learning and optimised billing/services for patients, doctors, and medical clinics.
Impact of AI in Healthcare
Increased Efficiency
Streamlined billing processes allow doctors to spend more time on patient care.
Enhanced Compliance
Reduces the risk of non-compliance and associated fines.
Better Patient Care
Optimises revenue and reduces administrative burden, allowing for more affordable and accessible healthcare services.
Future Development
Future iterations of MediBetter will integrate with existing medical software ecosystems, facilitating greater uptake and expanding its use across a wider GP and clinic population. The addressable market for MediBetter is substantial, promising significant improvements in medical billing practices and patient care.
Conclusion
Our work on MediBetter showcases Intergy's expertise in developing custom software solutions that address complex industry challenges. By leveraging advanced AI technologies, we created a tool that not only enhances billing compliance and efficiency for GPs but also contributes to the broader goal of improving healthcare quality and accessibility for the wider community.
For more information or to discuss how Intergy can help your organisation with custom software solutions, please contact us.
This case study highlights our capabilities in developing innovative, AI-driven software applications tailored to specific industry needs. It underscores the transformative potential of AI in the medical and healthcare sector, demonstrating how technology can improve efficiency, compliance, and overall patient care.