The healthcare domain is facing extreme pressure due to the rising medical emergencies prevailed since the time of the pandemic. The sector needs to be futuristic ready while providing digital healthcare solutions to people far and wide. So, for this, it is essential to maintain the capability, reliability, performance, safety, integration, and efficiency of the healthcare software. In the last part of our discussion, we highlighted what it actually takes to perform result-oriented healthcare software testing, vulnerabilities, and types. As promised, we will be talking about tips & tricks for testing the healthcare application or software.
In case, you have not referred to our part 1 discussion, then check it out here: A Beneficial Guide to Test a Healthcare Software-Part 1
So, our main point of discussion will roam around the following:
* Basic Entities of Healthcare System
* Basic Terminology to Look for
* Testing of Provider System
* Testing of Broker System
* Testing of Member System
* Testing of Claim System
* Testing of Finance System
* Testing of Member System
* Testing of Broker Portal
* Final Note
Basic Entities of a Healthcare System
For doing quality, unit, regression, platform, multifunctional, or even security testing of a healthcare system. It is important to know the various entities like the following:
* Provider: Doctors, medical representatives, etc.
* Patients: Patients enrolled for the treatment
* Regulatory Authority: Medical authorities that regulate the functioning of hospitals.
* Healthcare and Life-Science solution vendors
You Should Know This Terminology Before Testing:
* Provider: It represents all the doctors, physicians, medical representatives, clinical and lab professionals of a particular hospital.
* Claim: It is a request of the medical claim which is being to a health insurance company affiliated with your hospital.
* Broker: It is the insurance professionals who negotiate on behalf of the insurance company.
* Finance: Expenditures that insurance companies pay to patients for all the medical expenses.
* CPT Code: It is a medical code that describes medical, surgical, and diagnosis services.
*HIPPA: It is a regulatory body that set the rules and regulations for hospitals, clinicians, healthcare providers, and health plan.
Tips & Process of Healthcare Software Testing
For a result-oriented healthcare software testing process, several test scenarios are created and tested according to different entities.
1. Testing of Provider System
* Access: Provider System should provide the access to enter, edit information, and save particular provider’s (doctor, medical representative, etc.) data.
* Positive Flow: It includes creating different test case scenarios for adding different types of provider’s data. Also, can change, edit, save, and inquire about the same.
* Negative Flow: It includes scenarios like adding incomplete information, save provider data with contract effective less than license data, and entering information that is already there.
* System Integration: Validate, if all the feeds that have been entered and changes made have been incorporated well or not.
2. Testing of Broker System
* Access: Broker (Insurance professionals) should allow to enter, add, edit, and save broker’s data.
* Positive Flow: It allows to enter, edit, and save a record of different brokers. Additional information on each broker’s commission and earnings should also be there.
* Negative Flow: Creating different negative test scenarios to check the impact of entering incomplete broker details, calculating the commission of a terminated broker, and calculating the commission of an invalid broker.
* System Integration: It validates the feed after incorporating all the changes at the broker portal, finance system, and member’s system.
3. Testing of Member System
A member system (insurance policy system) of a healthcare domain comprises of different functionings like the following:
* Enroll, terminate, re-instate, or re-enroll a member.
* Add and remove a dependent
* Generate the premium bill
* Processing premium payments
a. Enrollment: It is about enrolling a person in an individual policy. A plan which is effective from the date an insured person starts paying the premium and is eligible for submitting claims.
b. Termination: In an individual policy, when it is terminated after which the insured person cannot be covered.
c. Reinstatement: It is a process of reinstating the terminated policy of the policyholder, especially when the policy is in the grace period of termination.
d. Re-enrollment: In case, when the policy is terminated and even the grace period is over, then the inactive policyholder can make a special request for re-enrollment for the same.
* Positive Flow: Creating different test scenarios as per varied conditions of the member.
* Enrolling different types of members with past, current, and future effective dates.
* Change the information & inquire about members.
* Generating a bill for an active member.
* Termination of the active member.
* Re-enrolling a terminated member.
* Reinstating a terminated member.
* Negative Flow: It includes creating scenarios like adding incomplete information of enrolling members and generating a premium bill for the terminated member.
* System Integration: It includes validating all the changes on the part of the member within the healthcare software.
4. Testing of Claims System
The claims part of the healthcare software consists of diagnosis code and procedure code information to settle the claim in detail.
* Diagnosis Code: It is the code that reflects that type of disease the patient had.
* Procedure Code: It refers to the treatment provided to the patient.
Positive Flow: It includes scenarios like adding, changing, and editing the claim details for the member.
Negative Flow: Entering a valid claim with an invalid diagnosis or procedure code. It also includes inactive partner ID or information of a terminated member.
System Integration: Validating all the changes being made in the claim system of the healthcare software.
5. Testing of Finance System
The Finance System of a healthcare domain does the crucial job of making payments to the recipients belong to different departments like Claims, Member, Provider, and Broker System.
The software testing scenarios are created as follows:
* Positive Flow: Scenarios are created to check whether the correct contact and payment details are added for the respective provider, member, broker, etc.
* Negative Flow: Testing and checking the results of making payment to the invalid member of the negative payment for the member, broker, or provider.
6. Testing of Member System
Member portal of the healthcare system does the following few functionings:
* View policy details and claim the status.
* Do any change in the policy.
* Make premium payments.
* Positive Flow: Make changes in the personal and policy details of the member.
* Negative Flow: Creating test scenarios to check what will happen after invalid credentials, making payment for an already paid bill, and making a payment with an invalid check.
7. Testing of Broker Portal
A Broker Portal within the healthcare system helps to view broker details, commission data, and make changes in the same.
* Positive Flow: Testing scenarios should include login and view the broker details, make changes in the same, and even looking at the commission data.
* Negative Flow: Creating a test scenario to check the impact of login with invalid credentials.
That’s all on the part of following useful tips & tricks of successfully testing a healthcare software.
Final Note
Well, that comprises a step-by-step process to test a healthcare software successfully and efficiently. It is a matter of great concern that interconnected medical applications should function appropriately with optimum speed, safety, and robustness.
You can get more details on the same and software testing services offered by TestingAgency. It is a leading and the best software testing company in India that has pioneer expertise in the healthcare domain.
Frequently Asked Questions
1. Why Healthcare Software Testing is Important?
Healthcare software relies on the utmost responsibility to bridge the gap between patients and quality medical services. With the emphasis on digital healthcare services, a majority of patients look for remote collaboration with doctors and medical experts. So, to maintain the flow and make sure to improve lives all around, it is important to check the accuracy, functionality, speed, and secrecy of healthcare software through testing.
2. How Much Time Does it Involve to Test a Healthcare Application?
There is not a fixed time to test healthcare software. Every software belongs to a medical organization has a different size, features, functionalities, users, and reach. So, we first have a strategic plan ready for your software and then decide the appropriate timeline accordingly.
3. What is the Total Cost of Software Testing Service?
The cost of healthcare software testing services depends on the complexity, size, features, resources, and reach of the application. At first, a strategy is created by our expert testing agents to identify the loopholes and missing touchpoints. After that only, the final cost is decided.
