A specialty referral
The next specialist receives the shared record and the documented referral context.
Polyclinics
Polyclinics. The complete journey.
Explore the people, decisions and connected records from the first action to the final handover.
5complete operational cases.Workflow illustrations
END-TO-END WORKFLOW CASE
A specialty referral
The next specialist receives the shared record and the documented referral context.
The situation
A patient is referred from one specialty to another within a polyclinic. The receiving clinician needs the referral reason, previous notes and available results.
What MANSOQ connects
Different specialties should add to one patient story.
The people involvedTreating clinicianAccess & coordinationFinance teamDepartment teamRevenue team
The complete journey
Document the first consultation
Treating clinicianRecord the assessment and the reason a specialist review is requested.
Assessment · Referral reasonCoordinate the referral
Access & coordinationArrange the receiving specialty appointment against the existing patient identity.
Referral · Specialty · AppointmentReview the shared context
Treating clinicianReview the referring note and relevant available results before documenting the specialist encounter.
Referring note · Results · EncounterConnect specialist requests
Treating clinicianLink the specialist’s orders and prescription to the receiving consultation.
Specialist note · Orders · PrescriptionReturn the care plan
Treating clinicianDocument the specialist assessment and follow-up responsibility for the referring service.
Assessment · Plan · Next serviceReview each service account
Finance teamKeep each encounter’s services and billing distinct while retaining the shared patient context.
Encounter charges · Patient account
The factors that make it work
Starting information
Assessment · Referral reason
Responsibility at every step
Each stage identifies the team, the action and the record carried forward.
An agreed operating scope
Confirm the selected capabilities, required companions and external connections during configuration.
Exceptions. A clear next responsibility.
The referral needs clarification
If the receiving service needs more information, record the missing referral context and return the task to the responsible service.
Responsible team · Treating clinicianAn incomplete referral or department request
Return the missing information to the referring or requesting team while retaining the original patient and encounter references.
Responsible team · Department teamA charge or payer response needs correction
Review the reason against the delivered service and agreed contract scope. Record the correction and next financial owner.
Responsible team · Revenue teamScope and delivery boundaries
MANSOQ CoreNative operation · Agreed connectionConfirm deployment scope
Outpatient CareNative operationConfirm deployment scope
Clinical Documentation & Care PlanningNative operationConfirm deployment scope
Patient AccessNative operationConfirm deployment scope
Orders, Results & MedicationNative operationConfirm deployment scope
Billing & FinanceNative operation · Agreed connectionConfirm deployment scope
External systems, device connections, catalogue licenses and national exchanges are activated only within their agreed delivery scope. The professionals retain clinical decisions.
END-TO-END WORKFLOW CASE
Diagnostic work in the care journey
The laboratory handles the order and specimen before the result returns to the clinician.
The situation
A specialty clinic requests a laboratory test. The laboratory processes the work, returns the result and the clinician documents its review.
What MANSOQ connects
The result must return to the patient and the consultation that requested it.
The people involvedTreating clinicianLaboratory teamRevenue teamDepartment team
The complete journey
Create the clinical request
Treating clinicianRecord the requested laboratory service in the correct specialty encounter.
Order · Encounter · Requested serviceReceive the laboratory work
Laboratory teamConfirm the patient, request and supported specimen workflow before processing.
Patient · Request · SpecimenProcess and document
Laboratory teamComplete the selected native laboratory work or agreed LIS exchange.
Laboratory activity · Source systemReturn the available result
Laboratory teamAttach the documented result to its request and patient encounter.
Result · Request referenceRecord clinical review
Treating clinicianReview the result professionally and document the next care action.
Review note · Care actionClose the service loop
Revenue teamReview the delivered service charge while retaining any remaining clinical follow-up.
Service charge · Follow-up
The factors that make it work
Starting information
Order · Encounter · Requested service
Responsibility at every step
Each stage identifies the team, the action and the record carried forward.
An agreed operating scope
Confirm the selected capabilities, required companions and external connections during configuration.
Exceptions. A clear next responsibility.
A specimen needs review
A rejected or incomplete specimen stays connected to the original request, with the laboratory’s documented reason and next responsibility.
Responsible team · Laboratory teamAn incomplete referral or department request
Return the missing information to the referring or requesting team while retaining the original patient and encounter references.
Responsible team · Department teamA charge or payer response needs correction
Review the reason against the delivered service and agreed contract scope. Record the correction and next financial owner.
Responsible team · Revenue teamScope and delivery boundaries
MANSOQ CoreNative operation · Agreed connectionConfirm deployment scope
LaboratoryNative operationConfirm deployment scope
Orders, Results & MedicationNative operationConfirm deployment scope
Outpatient CareNative operationConfirm deployment scope
Billing & FinanceNative operation · Agreed connectionConfirm deployment scope
Clinical Documentation & Care PlanningNative operationConfirm deployment scope
Patient AccessNative operationConfirm deployment scope
External systems, device connections, catalogue licenses and national exchanges are activated only within their agreed delivery scope. The professionals retain clinical decisions.
END-TO-END WORKFLOW CASE
Medication, from request to dispensing
Clinical prescribing connects to pharmacy operation and stock responsibilities.
The situation
A patient leaves a specialist consultation with a prescription. The polyclinic pharmacy reviews, dispenses and records the selected medication work.
What MANSOQ connects
Prescribing, dispensing and stock movement need distinct responsibilities in one connected path.
The people involvedTreating clinicianPharmacy teamDepartment teamFinance teamRevenue team
The complete journey
Document the prescription
Treating clinicianRecord the clinician’s prescription against the specialty encounter.
Prescription · Clinician · EncounterReceive the pharmacy work
Pharmacy teamVerify the patient and prescription context within the selected pharmacy scope.
Patient · Prescription referenceReview the medication request
Pharmacy teamDocument the pharmacist’s review and any clarification needed from the prescriber.
Pharmacy review · ClarificationRecord the dispensing step
Pharmacy teamRecord the agreed dispensing activity against the prescription and patient.
Dispensing record · PrescriptionConnect stock responsibility
Department teamLink recorded dispensing to inventory responsibilities where inventory is included.
Dispensing · Stock movementComplete the account and follow-up
Finance teamReview medication charges and preserve documented follow-up for the care team.
Medication charge · Care follow-up
The factors that make it work
Starting information
Prescription · Clinician · Encounter
Responsibility at every step
Each stage identifies the team, the action and the record carried forward.
An agreed operating scope
Confirm the selected capabilities, required companions and external connections during configuration.
Exceptions. A clear next responsibility.
An unavailable item or unclear prescription
An unavailable item or unclear prescription returns to the responsible pharmacist and prescriber; the software does not choose a substitute treatment.
Responsible team · Pharmacy teamAn incomplete referral or department request
Return the missing information to the referring or requesting team while retaining the original patient and encounter references.
Responsible team · Department teamA charge or payer response needs correction
Review the reason against the delivered service and agreed contract scope. Record the correction and next financial owner.
Responsible team · Revenue teamScope and delivery boundaries
MANSOQ CoreNative operation · Agreed connectionConfirm deployment scope
Orders, Results & MedicationNative operationConfirm deployment scope
PharmacyNative operationConfirm deployment scope
InventoryNative operationConfirm deployment scope
Billing & FinanceNative operation · Agreed connectionConfirm deployment scope
External systems, device connections, catalogue licenses and national exchanges are activated only within their agreed delivery scope. The professionals retain clinical decisions.
END-TO-END WORKFLOW CASE
Eligibility to reconciliation
Revenue teams follow the visit’s insurance and financial work through the payer response.
The situation
An insured specialty visit includes diagnostics and medication. The revenue team follows coverage, approvals, claims and payment allocation across those services.
What MANSOQ connects
Several departments can contribute to one claim without losing the origin of each service.
The people involvedAccess & coordinationRevenue teamDepartment teamFinance team
The complete journey
Verify coverage
Access & coordinationRecord eligibility and the relevant coverage context for the visit.
Eligibility · Coverage · EncounterFollow service approvals
Revenue teamConnect required preauthorization requests and payer decisions to the requested services.
Service · Authorization · ResponseCapture delivered services
Department teamRecord consultation, diagnostic and pharmacy activity with its encounter reference.
Department activity · Charge referenceReview and submit the claim
Revenue teamReview the claim work items and use the agreed, activated exchange channel.
Claim · Submission · Exchange traceResolve payer responses
Revenue teamAssign rejection reasons for correction, review and documented resubmission where needed.
Response · Reason · ResubmissionReconcile the remittance
Finance teamMatch payer remittance to claim records and assign remaining financial differences.
Remittance · Claim · Difference
The factors that make it work
Starting information
Eligibility · Coverage · Encounter
Responsibility at every step
Each stage identifies the team, the action and the record carried forward.
An agreed operating scope
Confirm the selected capabilities, required companions and external connections during configuration.
Exceptions. A clear next responsibility.
A partially paid claim
A partially paid claim keeps the paid allocation and unresolved lines separate, with a documented reason and follow-up owner.
Responsible team · Finance teamAn incomplete referral or department request
Return the missing information to the referring or requesting team while retaining the original patient and encounter references.
Responsible team · Department teamA charge or payer response needs correction
Review the reason against the delivered service and agreed contract scope. Record the correction and next financial owner.
Responsible team · Revenue teamScope and delivery boundaries
MANSOQ CoreNative operation · Agreed connectionConfirm deployment scope
Revenue Cycle ManagementNative operation · Agreed connectionConfirm deployment scope
EligibilityNative operation · Agreed connectionConfirm deployment scope
ClaimsNative operation · Agreed connectionConfirm deployment scope
ReconciliationNative operation · Agreed connectionConfirm deployment scope
PreauthorizationNative operation · Agreed connectionConfirm deployment scope
Charge CaptureNative operation · Agreed connectionConfirm deployment scope
Denials & ResubmissionNative operation · Agreed connectionConfirm deployment scope
RemittanceNative operation · Agreed connectionConfirm deployment scope
Payer ContractsNative operation · Agreed connectionConfirm deployment scope
NetworksNative operation · Agreed connectionConfirm deployment scope
Benefits & Cost SharingNative operation · Agreed connectionConfirm deployment scope
Tariffs & Price ListsNative operation · Agreed connectionConfirm deployment scope
RCM ReportingNative operation · Agreed connectionConfirm deployment scope
External systems, device connections, catalogue licenses and national exchanges are activated only within their agreed delivery scope. The professionals retain clinical decisions.
END-TO-END WORKFLOW CASE
From a service record to a traceable coding decision.
Connect supported SBS mapping, provider services and separate payer tariff responsibilities.
The situation
A polyclinic introduces a service into its billing catalogue. Coding and revenue teams must agree the supported code mapping and its payer price rules.
What MANSOQ connects
A service code and a payer tariff answer different questions.
The people involvedDepartment teamRevenue teamFinance team
The complete journey
Identify the provider service
Department teamDocument the service description and operational department.
Service · Description · DepartmentConfirm the catalogue scope
Revenue teamConfirm the supported SBS release and permitted catalogue usage.
Release · Catalogue scope · RightsReview the service mapping
Revenue teamReview the proposed provider-to-code mapping and record the responsible decision.
Provider service · Code · ReviewDefine payer tariff context
Finance teamRecord the separate contract price and tariff rules for the service.
Contract · Tariff · PriceValidate an encounter example
Revenue teamReview a selected service charge against its mapping and agreed tariff.
Charge · Mapping · Tariff versionRecord approved use and changes
Revenue teamRetain the reviewed mapping and assign responsibility for later catalogue changes.
Approved mapping · Change responsibility
The factors that make it work
Starting information
Service · Description · Department
Responsibility at every step
Each stage identifies the team, the action and the record carried forward.
An agreed operating scope
Confirm the selected capabilities, required companions and external connections during configuration.
Exceptions. A clear next responsibility.
The code mapping is uncertain
An uncertain mapping is held for responsible coding review. Catalogue tooling does not grant licensing rights or define payer reimbursement automatically.
Responsible team · Revenue teamAn incomplete referral or department request
Return the missing information to the referring or requesting team while retaining the original patient and encounter references.
Responsible team · Department teamA charge or payer response needs correction
Review the reason against the delivered service and agreed contract scope. Record the correction and next financial owner.
Responsible team · Revenue teamScope and delivery boundaries
MANSOQ CoreNative operation · Agreed connectionConfirm deployment scope
SBS Specific Mapping ToolingNative operation · Agreed connectionConfirm deployment scope
Full Supported SBS Catalogue ToolingNative operation · Agreed connectionConfirm deployment scope
Tariffs & Price ListsNative operation · Agreed connectionConfirm deployment scope
Revenue Cycle ManagementNative operation · Agreed connectionConfirm deployment scope
EligibilityNative operation · Agreed connectionConfirm deployment scope
PreauthorizationNative operation · Agreed connectionConfirm deployment scope
Payer ContractsNative operation · Agreed connectionConfirm deployment scope
NetworksNative operation · Agreed connectionConfirm deployment scope
Benefits & Cost SharingNative operation · Agreed connectionConfirm deployment scope
Charge CaptureNative operation · Agreed connectionConfirm deployment scope
ClaimsNative operation · Agreed connectionConfirm deployment scope
Denials & ResubmissionNative operation · Agreed connectionConfirm deployment scope
RemittanceNative operation · Agreed connectionConfirm deployment scope
ReconciliationNative operation · Agreed connectionConfirm deployment scope
RCM ReportingNative operation · Agreed connectionConfirm deployment scope
External systems, device connections, catalogue licenses and national exchanges are activated only within their agreed delivery scope. The professionals retain clinical decisions.