Imagine walking into a GP’s clinic, and your doctor seems hesitant—less about diagnosing your illness and more about properly billing for the services rendered. This odd reality is borne out of Australia's Medicare Benefits Schedule (MBS), an essential yet notoriously complex system of financial assistance for healthcare providers. While MBS aims to make medical care more affordable, it has inadvertently become a labyrinthine challenge, leaving doctors both confused and concerned about compliance.
That’s where the innovative minds at Sydney-based Intergy Consulting and Far North Queensland’s MediBetter step in. Together, they are creating artificial intelligence (AI)-powered billing optimization tools to rejuvenate the MBS landscape, all while running these solutions on Microsoft's Azure Cloud. This cutting-edge collaboration isn’t just about solving a financial headache—it’s about transforming the entire primary healthcare billing experience.
University of Sydney researchers found in a 2023 study that the fear isn't unfounded. Doctors, erring on the side of caution, often charge Medicare less than they should. The financial implications? A whopping $351 million shortfall in 2021-22. This under-utilization deprives doctors and clinics of revenue, while also unnecessarily increasing out-of-pocket expenses for patients. The ripple effect is stark: reduced access to care and a system that fails society on both ends.
MediBetter, co-founded in 2023, is spearheading two distinct AI solutions:
So next time your GP conducts an ECG or provides co-billing care, take a moment to appreciate the silent brilliance of AI working behind the scenes. Powered by Microsoft Azure and crafted by empathetic developers, MediBetter’s solutions are giving Australian healthcare its groove back. How’s that for a prescription?
Source: iTnews Intergy Consulting and MediBetter worked to build AI powered MBS billing optimisation solutions for GPs on Microsoft Azure
That’s where the innovative minds at Sydney-based Intergy Consulting and Far North Queensland’s MediBetter step in. Together, they are creating artificial intelligence (AI)-powered billing optimization tools to rejuvenate the MBS landscape, all while running these solutions on Microsoft's Azure Cloud. This cutting-edge collaboration isn’t just about solving a financial headache—it’s about transforming the entire primary healthcare billing experience.
The MBS Paradox: A Double-Edged Sword
At its core, the Medicare Benefits Schedule should empower doctors to focus on patient care without constantly worrying about underbilling or overbilling. Yet, for General Practitioners (GPs) across Australia, the 6000+ item numbers in the MBS catalog provoke quite a dilemma. This exhaustive list not only adds unnecessary complexity but creates fear; doctors are terrified of billing errors that might appear fraudulent during audits.University of Sydney researchers found in a 2023 study that the fear isn't unfounded. Doctors, erring on the side of caution, often charge Medicare less than they should. The financial implications? A whopping $351 million shortfall in 2021-22. This under-utilization deprives doctors and clinics of revenue, while also unnecessarily increasing out-of-pocket expenses for patients. The ripple effect is stark: reduced access to care and a system that fails society on both ends.
Bringing Intelligence to Billing: MediBetter’s AI-powered Solutions
Understanding this multi-layered problem, MediBetter has built AI tools that leverage Microsoft Azure to streamline MBS utilization. The goal? To make billing as intuitive as writing a consultation note.MediBetter, co-founded in 2023, is spearheading two distinct AI solutions:
1. BOSS (Billing Optimization and Support Software)
Scheduled for release in early 2025, BOSS is an intelligent billing optimizer that works hand in hand with GP consultation notes. Here's how it operates:- Real-time Analysis: BOSS reads consultation notes and cross-references them with the MBS catalog.
- Automated Insights: Item numbers that align with the services provided are flagged, effectively reducing missed billing opportunities.
- Compliance Guidance: For GPs worried about audits, BOSS clarifies MBS compliance issues, making fear-driven underbilling a thing of the past.
2. MIA (MBS Interpretation Assistant)
Currently in beta, MIA functions like a specialized AI assistant tailored for GPs and clinic staff. Think about MIA as the ChatGPT of MBS billing. Its features include:- Instant Search: Provides quick and accurate access to MBS guidelines and item numbers, eliminating the need for laborious manual lookups.
- Co-Billing Expertise: Simplifies complex billing scenarios, such as combining multiple relevant MBS item numbers.
- Administrative Relief: Reduces the need for time-consuming support calls and email queries.
Why Azure? The Tech Foundation
Intergy Consulting’s CTO could have chosen many platforms, but Microsoft Azure shines for healthcare AI. Here's why Azure fits like a glove:- Scalability: As MediBetter aims to onboard 6000+ GPs within 12 months, Azure’s elastic cloud capacity ensures it can scale without skipping a beat.
- Security-Compliant AI: Handling sensitive health-related data requires best-in-class security. Azure provides HIPAA compliance and advanced encryption features, meeting both Australian and global standards.
- AI as a Service: Azure’s built-in AI tools streamline development cycles, enabling Intergy Consulting to focus on proprietary algorithms rather than reinventing the wheel.
- Integration Capabilities: The platform supports seamless integration with practice management systems, ensuring BOSS and MIA fit smoothly into existing clinical workflows.
The Social Impact: Beyond GP Revenues
While MediBetter’s billing tools offer clear financial benefits, their impact ripples across multiple facets of the healthcare ecosystem:- Improved Access to Healthcare: Patients bear fewer out-of-pocket expenses, making essential consultations affordable.
- Accurate Health Data: By prompting GPs to use the correct item numbers for all procedures, MBS data becomes more reliable, improving nationwide health insights.
- Staff Efficiency: Automated solutions free up clinic staff from tedious paperwork, giving them more time for patient-centric activities.
The Road Ahead: Strategic Scaling
MediBetter is ambitious. They aim to capture at least 20% of Australia's GP market within a year of launching BOSS. The strategy involves:- Building Partnerships: Negotiating alliances with clinical education companies, some of which have access to over 20,000 clinicians.
- Expanding Integrations: Enhancing their solutions to connect with existing practice management and clinical software.
A Closing Thought
The collaboration between MediBetter and Intergy Consulting isn’t simply about coding intelligent billing software. It’s about re-engineering the relationship between Australian practitioners and the MBS system. What was once a source of confusion and fear will now be a pathway to efficiency and balance—accessible, accurate, and empowering.So next time your GP conducts an ECG or provides co-billing care, take a moment to appreciate the silent brilliance of AI working behind the scenes. Powered by Microsoft Azure and crafted by empathetic developers, MediBetter’s solutions are giving Australian healthcare its groove back. How’s that for a prescription?
Source: iTnews Intergy Consulting and MediBetter worked to build AI powered MBS billing optimisation solutions for GPs on Microsoft Azure