These benefits allow families to receive cashless treatments without upfront payments, with hospitals claiming reimbursements from the government and insurance providers.
The HealthCare Flow System is a comprehensive software solution designed to streamline healthcare operations in hospitals under a sponsored health scheme. This system facilitates patient registration, treatment package selection, claim processing, and financial reconciliation, ensuring efficient and transparent management of healthcare benefits. HealthCare Flow System is particularly useful for hospitals handling a high volume of patients, where tracking treatments, expenses, and reimbursements is critical.
In this case study, we explore how HealthCare Flow System was developed and deployed for a state health initiative aimed at providing affordable healthcare to families. The system integrates patient authentication, treatment workflows, and multi-party approvals, reducing administrative burdens and minimizing errors. Built using modern technologies, HealthCare Flow System ensures secure, scalable, and user-friendly operations.
The HealthCare Flow System follows a structured process from patient arrival to claim settlement. Below is a clean process flow diagram represented in a simple flowchart format for clarity. The diagram outlines the key steps, ensuring a logical progression
This flowchart illustrates the end-to-end workflow in HealthCare Flow System. Patients are registered using their social identity number, authenticated via biometrics (fingerprint or facial recognition) or OTP (one-time password) if biometrics are not feasible, such as for unconscious patients. Hospitals select from 20-30 predefined treatment packages (e.g., cancer care, cardiac procedures, or general surgery), each with associated costs covered under the scheme. Expenses are tracked in real-time, and upon discharge, claims are raised for a mix of government subsidies and insurance payouts.
HealthCare Flow System includes a range of features to support efficient healthcare transactions:
Manages treatment eligibility and insurance coverage by allowing hospitals to request and receive approvals before starting procedures.
Facilitates timely submission, processing, and settlement of health claims, with automated tracking of supporting documents.
Ensures accurate and up-to-date beneficiary, treatment, and hospital records, including patient history and expense logs.
Supports cashless treatment and easy verification of patient eligibility and treatment details through seamless integration with hospital systems.
Enhances transparency by tracking all transactions, ensuring proper fund utilization and audit trails.
Generates reports for financial analysis and reconciliation to maintain accurate records of transactions.
Additional general features in HealthCare Flow System include user dashboards for real-time monitoring, automated notifications for approvals/denials, role-based access controls for security, and integration with external systems for biometric/OTP authentication. The system also handles unspecified packages by routing them to a medical committee for review.
HealthCare Flow System was built using a robust, modern technology stack to ensure reliability, scalability, and security:
.NET Core – Provides a high-performance framework for handling complex business logic, API integrations, and secure data processing.
React – Offers a dynamic, responsive user interface for easy navigation, real-time updates, and intuitive forms for registration and claims.
SQL Server – Manages structured data storage for patient records, treatment packages, claims history, and reports, with strong support for transactions and queries.
This stack enables secure handling of sensitive health data, compliance with standards and easy scalability for growing hospital networks.
HealthCare Flow System defines clear roles to ensure smooth operations and accountability:
These roles collaborate within HealthCare Flow System, with automated workflows routing tasks to the appropriate users.
In deployment, HealthCare Flow System was rolled out across 50 empanelled hospitals, handling over 10,000 patients monthly. The system reduced claim processing time from weeks to days, minimized errors in package selection, and improved transparency through digital audits. Hospitals reported a 30% increase in efficiency, while patients benefited from faster approvals and cashless care.
One notable success was during a surge in critical illness cases, where HealthCare Flow System's real-time balance checks prevented over-utilization of benefits. The biometric/OTP authentication ensured secure registrations, reducing fraud risks.
HealthCare Flow System exemplifies how technology can transform healthcare administration, making it more accessible and efficient. By automating workflows, ensuring multi-level approvals, and providing detailed tracking, HealthCare Flow System supports government health schemes effectively. This solution is customizable for similar initiatives, offering a scalable platform for client needs in healthcare management.
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