Healthcare Platform – Comprehensive Digital Healthcare Ecosystem
Our Healthcare Platform is an integrated, end-to-end system designed to streamline healthcare operations, enhance patient care, and automate critical administrative processes. It serves as a prevention, diagnostic, and financial management system, ensuring seamless interoperability between infrastructure, hardware, software, and connectivity services. This platform is a vital component in any modern healthcare ecosystem, fostering efficient communication and coordination among healthcare providers, patients, payers, and regulatory bodies.
With our Healthcare Platform, organizations can access a full suite of automation-driven capabilities, including:
- Patient Registry & Portals – Centralized patient records with secure access for providers and patients.
- Radiology & Laboratory Information Systems – AI-powered diagnostics, workflow automation, and data integration.
- E-Prescription & Sick Leave Management – Digital prescribing, automated compliance tracking, and authorization workflows.
- Referral & Health Insurance Modules – Seamless payer-provider integration for real-time eligibility and authorization.
- Billing & Revenue Cycle Management – AI-driven claims processing, automated claims editing, real-time adjudication, and fraud detection.
- Claims Process Automation – Optimized claim validation, AI-powered error detection, automated resubmissions, and predictive analytics to minimize denials and accelerate reimbursements.
By integrating claims automation into the core of our Healthcare Platform, we empower healthcare providers to reduce administrative burdens, enhance financial performance, and ensure compliance with payer regulations, ultimately delivering a more efficient and sustainable healthcare ecosystem.
Standard features:
- Uses Standard Protocols
- Easy Integration with Other Medical or IT Systems
- Microservice Architecture for Flexible System Adaptation
- Vertical Integration and Central Management
- Paperless Business Processes
- Possibility for Integration of Telemedicine Modules
- Mobile and Wireless Solutions for Connection
- Automated Claims Processing & Adjudication
- Real-Time Eligibility & Authorization Checks
- Configurable Claims Rules Engine
- AI-Powered Revenue Cycle Optimization
- Patient Billing Link to Financial System or ERP
- Allows the Application of Special Services or Healthcare Procedures
Benefits:
- Ensuring the Quality of Readings – Uses validation algorithms to verify interval and register readings, ensuring data accuracy.
- Filling in Missing Data – Completes missing intervals or full periods using estimation algorithms such as interpolation, historical estimates, and replacement profiles.
- Correction of Values – Enables manual correction of individual or grouped values or applies selected algorithms for automated adjustments.
- Calculation of Replacement and Aggregate Profiles – Generates replacement profiles, aggregate profiles, and predictive profiles using various algorithms.
- Lower Denial Rates – Automated validation minimizes errors, ensuring higher claim acceptance rates.
- Faster Reimbursements – Reduced manual intervention accelerates claim approvals and payments.
- Reduced Manual Claim Reviews – AI-powered adjudication significantly decreases the need for manual claim corrections and processing.
- Operational Cost Savings – AI-driven automation reduces administrative overhead and staff workload
Basic function centralization (eHealth cloud) reduces the implementation footprint, increases doctor effectivity and simplifies the pathway for the patient’s access to the best healthcare possible (not just the closest one).
Main objectives:
- Creating a unique information platform for communication between health care providers (services) and health care users (services) in the field of preventive health care (screening) and diagnostics
- Generation of relevant data at the place of their origin (practice) by relevant persons (health care providers) and direct formation of an electronic database
- Availability of relevant data to authorized users at any time, in any place and at all levels (health care users, health care providers, managers, analysts, decision makers …)
- Reduction the possibility of error by using predefined controls and avoiding subsequent rewriting and data entry
- Automation of claims processing & adjudication – Enhancing efficiency through AI-driven claim validation, reducing manual reviews, and accelerating reimbursements
- Real-Time insurance eligibility & authorization checks – Seamless integration with payers to verify coverage and approvals instantly
- AI-driven fraud detection & compliance monitoring – Ensuring data integrity by identifying anomalies and enforcing regulatory standards
- Centralized rules management for claims editing – Enabling uniform claim validation rules across all healthcare providers and payers
- Optimized revenue cycle management – Enhancing billing, coding, and financial workflows to improve healthcare institution profitability
- Reduction of operating costs of health care institutions through a complete transition to business without film and paper / electronic business
- Collection of data from each intervention / creation of a database, as a basis for analysis, reporting and development of activity proposals
- Definition of a unified information system for archiving, analysis and processing of medical data in radiological diagnostic centers
- Remote reading and exchange of results and operational exchange of data on performed screening tests
- Overcoming the problem of lack of adequate radiological staff in certain geographical areas
- Reorganization and acceleration of business processes as well as increasing labor productivity and utilization of existing radiological resources
NITES Healthcare Platform for prevention and diagnosis architecture is a three-tier architecture in accordance with the CEN prEN 12967 standard, better known as HISA (Healthcare Information Systems Architecture).
