Development of an information application that can be used to optimize the communication processes of a service provider in the area of care based on selective contracts. The CRM system provides data on doctors, insured persons, services provided and bills, and supports the certification processes for medical assistants and practice information systems. The software also contains functions for analysis and quality assurance of bills to health insurance companies, for processing of inbound settlement data and documentation of account movements.
Supplement
The system is based on the .Net (C#), WinForms and Entity Framework technologies: the application uses the MVP design pattern throughout; upon data access, views and complex types are used to isolate the functional model from the physical data model. The development process is SCRUM with support from SpecLog and TFS. The company has a SCRUM master who provides the required expertise to all project teams. The length of an iteration is 14 days. Cooperation with the department is controlled by the customer PO. The central requirement for the software is the development of comprehensive authorizations management that can be maintained efficiently, as the software accesses social data.
Subject description
The term “general practitioner centered health care” refers to a form of care in the German health care system, in which control and savings effects are achieved by tying patients to general practitioners and their “gatekeeping” function. Working on behalf of general practitioners, the customer settles bills for services with health insurance companies. The information system is used primarily to answer the questions from doctors on the contents of the bills. To enable this, comprehensive data must be prepared (e.g. status of insuree as recipient of general practitioner-centered care, reasons for rejection of services by the health insurance company, etc.). Further functions of the application result from the need to consolidate the existing software landscape in as few programs as possible.