Healthcare / Operations
Healthcare / Operations case study — how Meritt Dev built and runs Hospice operator: supply invoices, room-and-board bills and Medicaid checks off the spreadsheet Hospice operator: supply invoices, room-and-board bills and Medicaid checks off the spreadsheet
A hospice operator across four US states, with 27 branches and 19 billing facilities, checked every medical-supply invoice line by line against its contract price list, reconciled nursing-home room-and-board invoices by hand against patient rosters and rate letters, and keyed bills into its accounting system manually.
Overview
We built the reconciliation platform its finance team now runs on. Meritt's co-founder led the implementation, working with our US partner studio.
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The challenge
Three different reconciliations, each with its own sources: supplier invoices against contract pricing, room-and-board bills against the clinical system's census and each patient's Medicaid share, and medical claims against CMS fee schedules. All of it under a healthcare data agreement, with access limited by role.
The team wanted every case reviewed by a person, with automation switched off until the numbers had been proven on real invoices.
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What we built
One application with role-scoped workflows: supplier invoice reconciliation with mailbox intake from a forwarding group, room-and-board reconciliation on a replica of the clinical system, Medicaid eligibility checks through a clearinghouse API, CMS rate parsers for physician, equipment and ambulance schedules, claims and denial letters, a prepaid close workflow, consent-packet review and per-patient payment PDFs ready for the accounting system.
AI extracts the fields from invoices and remittances, and a knowledge layer over the company's documents answers questions within each role's permissions.
Next.js on Azure Container Apps with Postgres, blob storage and Azure AI Search, provisioned with Terraform.
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Where it is now
Data agreement signed and environment live on 22 July; first real supplier file on 10 August; supervised production testing on real invoices from 9 September.
One August week of supplier invoices: 571 invoices and 3,070 lines processed with 912 exact matches, 19 lines flagged over contract and nothing quarantined. Room-and-board payables in the thousands of dollars per facility now go out as reviewed, documented approvals instead of spreadsheet reconciliations.
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