Claiming.com.au is set to launch an Australian Medicare API that should drastically improve eClaiming processes for developers working with the state funded and run healthcare system. Although Medicare has served as the primary healthcare system in Australia for almost 30 years, the system has run into major bottlenecks as its technological infrastructure has not always kept up with demand. The API allows software vendors to integrate online claiming with Medicare and the Department of Veteran's Affairs.
Sam Stewart, Claiming Co-Founder and CEO, explained:
“The way that we improve it is really two-fold. One is an efficient queueing system so that developers will send [a claim] through to us and we will hold it and ping it off to Medicare at a rate that won't send Medicare down. We will meter it and keep sending it through to Medicare at a rate that they can handle, but also send it back out to whoever is integrated at the other end. The other is the pre-validation....We can say 'you have put these three item numbers together on a claim and that can't go through."
The API is set to launch in about a week (see the countdown at the home site). Stewart founded the company (along with his father Tony Stewart and developer Damien Whitten) last year after years of listening to medical billing horror stories from his father. Tony Stewart founded medical billing provider, Cutting Edge Software, and has 30 years of experience in the industry. Claiming is part reactionary to Medicare eClaiming issues, and part forward thinking as the medical billing community acquaints itself with new technology.
Pubic documentation for the API is not currently available. For those interested in receiving more details, and solving claiming issues with existing applications, contact the team for information. The API looks to increase stability, reduce development time, improve customer experience, and reduce claim rejections.
State run healthcare systems are currently under heightened scrutiny because of the botched roll out of the US' Affordable Care Act. At the heart of the US' difficulties sits an inadequate IT infrastructure. Perhaps private start-ups like Claiming can ease the pain of such shortcomings with forward thinking software solutions.