Question

There are three primary steps in our order processing system:

Intake: we validate the accuracy of the information submitted on the prescription to ensure it is complete and sufficient. If the prescription is incomplete, we need to coordinate with the physician’s office to retrieve the requisite data.

Product Selection and Shipping: we select the best product for the patient among dozens of options based on the information received on the prescription. BHK health carries most products, and for these, we trigger a shipment from one of our warehouses. If the best product for the patient’s needs is one that we don’t carry, we send the order to a partner DME provider.

Claim Submission: after we have delivered the product, we submit a claim to the patient’s insurance company to be paid. Sometimes we are paid in full, but sometimes the insurance company denies our claim. When this happens, we review the denial reason, correct the information on the claim, and resubmit it.

A physician writes an order for a catheter. Please draw out a process flow that captures the high-level steps and branches the system outlined above, particularly in regards to intake and claim submission.

Answer 1