From the referral to the claim, on one hospital record
Hospital margins are too thin for hand-worked admin. The referral, pre-admission, theatre, the ward, discharge and coding all sit on the patient's episode, so nothing is typed twice and the claim builds from what was recorded.
Follow one patient through a private hospital, from the surgeon's request to the claim. Each step is a page: who takes part, what happens and what it hands to the next.
From referral to claim, connected
Centralise referrals and lose the fax machine
Referrals arrive by fax, email, phone and portal, and each one enters a different queue. Checking Medicare eligibility, national health identifiers (IHIs) and DVA entitlements before admission is manual and delays everything. When a patient is ready to leave, arranging home care, allied health and follow-up means phone calls and faxes to several providers. HealthOS centralises referrals, verifies Medicare before admission and coordinates discharge to community care.
One referral inbox
Email, fax, portal and phone referrals land in a single queue. Integration with your organisation's email platform parses email referrals automatically.
- Unified referral inbox
- Email referral parsing
- Triage and priority assignment
- Pre-admission pipeline
Medicare verification, built in
Verify Medicare numbers, check DVA eligibility and look up the national health identifier (IHI) directly from the patient record, before admission.
- Medicare number validation
- DVA eligibility checking
- IHI lookup via the HI Service
- Secure government login (PRODA)
Pre-admission starts on the patient's couch
HealthOS Connections is for patients as well as families. Before admission day, patients open one emailed link, with no password and no app store, and complete their pre-admission from home: health questionnaires, what-to-expect education packs and the documents that need signing, informed financial consent included. By the time they arrive, the paperwork is done and the clinical team already has the answers. See the patient portal.
- Pre-admission forms completed before arrival
- Education packs walk patients through their procedure
- Informed financial consent signed electronically
- The same portal keeps family in the loop during the stay
Theatre lists, safety checks and recovery on the same episode
Cases are booked onto theatre sessions from the people waiting for them, with each surgeon's equipment preferences ready for the list. On the day, the surgical safety checklist (sign in, time out, sign out), the surgical counts, the anaesthetic record and the recovery record are all kept on the patient's episode, and recovery discharges the patient to the ward. Paper that still comes out of theatre is scanned on the unit's multifunction device and filed to the episode by its number.
- Session booking and theatre utilisation
- Surgeon equipment preferences
- Surgical safety checklist and surgical counts
- Anaesthetic and recovery records
- Scanned documents filed to the episode, or held for review
Estimates and accounts from your own prices
Private hospital billing runs on the hospital's own chargemaster: accommodation, theatre bands tied to their MBS items, pharmacy and sundries, each at standard and contracted rates. Each health fund contract carries its per diem, case payment and DRG rates. The numbered estimate a patient signs before admission is worked out from the MBS fees for the listed items, the fund's contracted rates and the patient's own excess from the fund eligibility check, and charges accrue on the episode as care is given.
- Chargemaster with standard and contracted rates
- Theatre bands and their billing rules
- Health fund contracts: per diem, case payment and DRG rates
- Prosthesis charges from the Prescribed List
- Informed financial consent estimates issued from the pre-admission
Discharge to community in one handoff
This is where sharing a platform pays off. When the receiving home care, aged care or allied health provider also works on HealthOS, discharge is a structured handoff instead of a fax. Send the referral and share the discharge summary. The community provider picks the person up on a pathway of their own, and the hospital can see it happen.
- Structured discharge referral to community and residential providers
- Discharge summaries assembled from the whole stay
- Diagnoses and procedures coded on the episode
- Follow-up and allied health coordination tracked on the pathway
Coding that follows the patient
The hardest part of coding an episode is telling what the patient arrived with from what the stay added. HealthOS holds the pre-admission record, so at admission it freezes a pre-existing baseline for the episode and the coder works on the difference: the principal diagnosis, additional diagnoses that affected management, and anything acquired on the ward. Condition onset flags and hospital-acquired complications come out of the same comparison.
- Pre-existing baseline built from the pre-admission record, referral and medications, and from My Health Record once that connection is live
- Coder worklist, HIM allocation and coding queries
- Hospital-acquired complication screening on the episode's own conditions
- Groups to MS-DRG today; AR-DRG to the official IHACPA specifications once certified
Claims built from the episode
Medicare, DVA and health fund in-hospital claims are built from the episode already recorded and sent through Eclipse in batches you can follow, and remittances reconcile against the claims they pay. Eclipse is in Notice of Integration testing with Services Australia.
Built-in connectors for acute care
The HI Service, PRODA, Eclipse and your email platform, with My Health Record in development. See government services.
See it in action
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