END-TO-END WORKFLOW CASE
The case, from start to finish.
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 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
External systems, device connections, catalogue licenses and national exchanges are activated only within their agreed delivery scope. The professionals retain clinical decisions.