Development of An Automated Medical Claim Processing (AMCP) Prototype

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For over 30 years, Dynamic Medical Services has been providing medical services for physicians and healthfacilities, including consulting, billing, technology, and training throughout Ontario. The company has alsodeveloped a number of specialized software applications, such as the Clearing House Model (CH) to facilitatethe needs of large clients that need to process a large number of complex medical claims and receive paymentfor these services. However, the current CH platform requires significant back-end manual intervention,processing, and delivery processes which could be improved through the implementation of available webservices and automation of some key processes.Although Dynamic Medical has significant experience and technical knowledge, they require technicalassistance to take advantage of current web and cloud-based technologies. In collaboration, Dynamic MedicalServices and Lambton College will focus on the design and development of a robust platform, utilizing the newand scalable technology stack to streamline the business workflow from intake to delivery through anautomated solution.The successful development and implementation of the final product will provide added benefit to DynamicMedical clients and enable the business to increase capacity. The improved process through automation ofmanual activities will result in saved time, improved accuracy due to reduced errors, and streamline thesubmission process of claims. The enhanced and simplified process will lead to market growth across Ontarioand inter-provincially. In turn, this will lead to the creation of additional jobs for technical and administrativestaff. Furthermore, this will also have a positive impact on primary care billers and hospitals, who will notlonger need to spend significant time following up on payment of services and with medical patients.