BookADoc Workflow: Insurance Handling

In the BookADoc workflow, there are two main types of insurance input methods: manual entry and file upload.

1. Manual vs. Upload Insurance Types

• Manual Entry:
  Users manually input insurance details during the workflow process.

• Upload Method:
  Users can upload an image or document containing insurance information (e.g., an insurance card).

2. File Upload Flow

When a file is uploaded during the BookADoc workflow:

1. File Storage

   • The uploaded file is stored in Azure Blob Storage.

2. OCR Extraction

   • A background job is dispatched immediately to trigger our OCR (Optical Character Recognition) service.
   • OCR extracts relevant insurance information from the uploaded file (e.g., member ID, plan name, payer).

3. Insurance Case Creation

   • An insurance case is created automatically on any of our connected EHR (Electronic Health Record) platforms such as:
     • Tebra
     • Axana
     • Or any other supported EHR

4. Eligibility Check

   • We perform an eligibility check on the extracted insurance information to verify:
     • Whether the insurance is valid and active
     • Whether it is in-network or out-of-network with respect to the provider the appointment was scheduled with

5. Document Upload to EHR

   • The uploaded insurance file is also attached to the patient’s profile in the EHR as part of their document records.

3. BizApp Integration

All insurance files and their associated validation statuses are also reflected in BizApp, our administrative portal.

• Appointment View:
  Providers can log into BizApp to view appointment details, including insurance information.

• Validation Status:
  BizApp clearly indicates whether the patient's insurance has been validated or not, giving providers immediate visibility into eligibility results.

Summary

This end-to-end flow streamlines insurance handling for both patients and providers, ensuring accurate intake, verification, and visibility across both clinical and administrative interfaces.