Method and system to analytically optimize telehealth practice-based billing processes and revenue while enabling regulatory compliance
A computer-implemented system includes a treatment apparatus configured to be manipulated by a patient while performing a treatment plan and a server computing device configured to execute an artificial intelligence engine to generate the treatment plan and a billing sequence associated with the treatment plan. The server computing device receives information pertaining to the patient, generates, based on the information, the treatment plan including instructions for the patient to follow, and receives a set of billing procedures associated with the instructions. The set of billing procedures includes rules pertaining to billing codes, timing, constraints, or some combination thereof. The server computing device generates, based on the set of billing procedures, the billing sequence for at least a portion of the instructions. The billing sequence is tailored according to a certain parameter. The server computing device transmits the treatment plan and the billing sequence to a computing device.
1. A computer-implemented system, comprising:
an electromechanical machine configured to be manipulated while the patient is performing a treatment plan;
a server computing device configured to generate the treatment plan and a billing sequence associated with the treatment plan, wherein the generation is configured to use an artificial intelligence engine, and wherein the server computing device:
generates, based on medical diagnosis code information which pertains to the patient, the treatment plan for the patient, wherein the treatment plan comprises a plurality of instructions for the patient, and further wherein, the plurality of instructions is associated with a set of billing procedures which comprise one or more rules pertaining to one or more billing codes, timing, constraints, or some combination thereof;
generates, based on the set of billing procedures, the billing sequence for at least a portion of the plurality of instructions, wherein the billing sequence is determined in part by using at least one parameter;
transmits the treatment plan and the billing sequence to a computing device;
controlling, based on the treatment plan, operation of the electromechanical machine by modifying one or more operating parameters of the electromechanical machine while the patient performs the treatment plan; and
determining, based on the patient's completed performance at least one billable session that comprises the treatment plan, an indication that billing is allowed and information comprising billing codes associated with the session.
2. The computer-implemented system of claim 1 , wherein the server computing device is further to distally control, based on the treatment plan, the electromechanical machine used by the patient to perform the treatment plan.
3. The computer-implemented system of claim 1 , wherein the at least one parameter is a fee to be paid to a medical professional, a payment plan for the patient to pay off an amount of money owed, a plan of reimbursement, an amount of revenue to be paid to an insurance provider, or some combination thereof.
4. The computer-implemented system of claim 1 , wherein the treatment plan is for habilitation, pre-habilitation, rehabilitation, post-habilitation, exercise, strength training, endurance training, weight loss, weight gain, flexibility, pliability, or some combination thereof.
5. The computer-implemented system of claim 1 , wherein the plurality of instructions comprises:
a plurality of exercises for the patient to perform,
an order for the plurality of exercises,
a frequency for performing the plurality of exercises,
a diet regimen,
a sleep regimen,
a plurality of procedures to perform on the patient,
an order for the plurality of procedures,
a medication regimen,
a plurality of sessions for the patient, or
some combination thereof.
6. The computer-implemented system of claim 1 , wherein the server computing device is further to cause presentation, in real-time or near real-time during a telemedicine session with another computing device of the patient, of the treatment plan and the billing sequence on the computing device of a medical professional.
7. The computer-implemented system of claim 1 , wherein the server computing device is further to:
receive, from the computing device, a first request pertaining to the billing sequence;
receive, from another computing device of an insurance provider, a second request pertaining to the billing sequence;
modify, based on the first request and the second request, the billing sequence to generate a modified billing sequence, such that the modified billing sequence results in funds being received sooner than had the billing sequence been implemented, an optimized total amount of the funds being received, an optimized number of payments being received, an optimized schedule for the funds being received, or some combination thereof.
8. The computer-implemented system of claim 1 , wherein the constraints further comprise constraints set forth in regulations, laws, or some combination thereof.
9. The computer-implemented system of claim 1 , wherein the server computing device is further to transmit the treatment plan and the billing sequence to be presented on a second computing device of the patient in real-time or near real-time during a telemedicine session in which the computing device of the medical professional is engaged.
10. A method for generating, by an artificial intelligence engine, a treatment plan and a billing sequence associated with the treatment plan, the method comprising:
generating, based on the medical diagnosis code information which pertains to a patient, the treatment plan for the patient, wherein the treatment plan comprises a plurality of instructions for the patient, and further wherein, the plurality of instructions is associated with a set of billing procedures which comprise one or more rules pertaining to one or more billing codes, timing, constraints, or some combination thereof;
generating, based on the set of billing procedures, the billing sequence for at least a portion of the plurality of instructions, wherein the billing sequence is determined in part by using at least one parameter;
transmitting the treatment plan and the billing sequence to a computing device;
controlling, based on the treatment plan, operation of an electromechanical machine by modifying one or more operating parameters of the electromechanical machine while the patient performs the treatment plan; and
determining, based on the patient's completed performance at least one billable session that comprises the treatment plan, an indication that billing is allowed and information comprising billing codes associated with the session.
11. The method of claim 10 , further comprising distally controlling, based on the treatment plan, an electromechanical machine used by the patient to perform the treatment plan.
12. The method of claim 10 , wherein the at least one parameter is a fee to be paid to a medical professional, a payment plan for the patient to pay off an amount of money owed, a plan of reimbursement, an amount of revenue to be paid to an insurance provider, or some combination thereof.
13. The method of claim 10 , wherein the treatment plan is for habilitation, pre-habilitation, rehabilitation, post-habilitation, exercise, strength training, endurance training, weight loss, weight gain, flexibility, pliability, or some combination thereof.
14. The method of claim 10 , wherein the plurality of instructions comprises:
a plurality of exercises for the patient to perform,
an order for the plurality of exercises,
a frequency for performing the plurality of exercises,
a diet regimen,
a sleep regimen,
a plurality of procedures to perform on the patient,
an order for the plurality of procedures,
a medication regimen,
a plurality of sessions for the patient, or
some combination thereof.
15. The method of claim 10 , further comprising causing presentation, in real-time or near real-time during a telemedicine session with another computing device of the patient, of the treatment plan and the billing sequence on the computing device of a medical professional.
16. The method of claim 10 , further comprising:
receiving, from the computing device, a first request pertaining to the billing sequence;
receiving, from another computing device of an insurance provider, a second request pertaining to the billing sequence;
modifying, based on the first request and the second request, the billing sequence to generate a modified billing sequence, such that the modified billing sequence results in funds being received sooner than had the billing sequence been implemented, an optimized total amount of the funds being received, an optimized number of payments being received, an optimized schedule for the funds being received, or some combination thereof.
17. The method of claim 10 , wherein the constraints further comprise constraints set forth in regulations, laws, or some combination thereof.
18. The method of claim 10 , further comprising transmitting the treatment plan and the billing sequence to be presented on a second computing device of the patient in real-time or near real-time during a telemedicine session in which the computing device of the medical professional is engaged.
19. A system, comprising:
a memory device storing instructions;
a processing device communicatively coupled to the memory device, the processing device executes the instructions to:
generate, based on the medical diagnosis code information which pertains to a patient, a treatment plan for the patient, wherein the treatment plan comprises a plurality of instructions for the patient, and further wherein, the plurality of instructions is associated with a set of billing procedures which comprise one or more rules pertaining to one or more billing codes, timing, constraints, or some combination thereof;
generate, based on the set of billing procedures, the billing sequence for at least a portion of the plurality of instructions, wherein the billing sequence is determined in part by using at least one parameter;
transmit the treatment plan and the billing sequence to a computing device;
control, based on the treatment plan, operation of an electromechanical machine by modifying one or more operating parameters of the electromechanical machine while the patient performs the treatment plan; and
determine, based on the patient's completed performance at least one billable session that comprises the treatment plan, an indication that billing is allowed and information comprising billing codes associated with the session.
20. The system of claim 19 , wherein the processing device is further to distally control, based on the treatment plan, an electromechanical machine used by the patient to perform the treatment plan.