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Detailed Gap Analysis
- KG will deploy the best possible combination of resource persons (Physician + Coder, Nurse + Coder, and Qualified Statistician) – experienced Physicians + Healthcare Administrators. Work closely with Coding Analyst and HIM team.
- Sample Chart Analysis based on International Statistics Norms and Best Practices.
- Detailed documentation review based on International Coding Guidelines, International Clinical Documentation Best Practices, DOH Adjudication Rules, and Clinical Practices.
- Engagement with Physicians (Consultants, Specialists, and Residents), Case Managers, Coding Teams, and RCM teams to understand current challenges.
- Extensive analysis of Length of Stay at DRG Level and comparisons against International Standards.
Operational Gap Analysis
- Identified training needs for physicians and other clinical teams, and training materials developed.
- Physician and Clinical Teams Engagement Model for CDI.
Enhancements
- Implement the Physician and Clinician Engagement Model for CDI.
- Training of Physicians, Case Managers, Coders, and RCM Teams on CDI.
- Develop CDI Guidelines for different categories of Medical and Clinical Teams.
- CDI always carries a risk of increased denials. Based on the industry experience in Abu Dhabi (with Daman, other payers, and Private Sector Hospitals) KG is capable of minimizing that risk through a Denial Prevention Programme.
- Monitor payer denials trends and provide training and documentation support for Physicians for continuous improvement (Programme Sustainability).
- Manage the CDI Programme with adequate resources and accountability.
- Actively support in reducing the length of stay in parallel to CDI.
Outcomes
Better cash flows and efficient management of working capital
Improved vendor relationships
Increased agility and better revenue management
Reduced payment cycle time
Efficient process control and auditing
Effective risk mitigation
CLIENT STORIES
Brands Trust Us
INSURANCE VERIFICATION
US optometry and vision care company effectively completes verification of 95% of insurances before appointment and shortens time taken to submit claims
MEDICAL BILLING & CODING
KGiS uses business process improvement capability to setup and effectively manage clearing house for a leading biometric testing and wellness company
ACCOUNTS-RECEIVABLES
Health screenings and wellness company reduces denials, realizes 84% of unpaid claims using KGiS’s RCM and analytics solutions
APPOINTMENT SCHEDULING
KGiS enables US physician practice setup and effectively manage centralized appointment scheduling operations
APPOINTMENT SCHEDULING
KGiS streamlines appointment scheduling for American dermatology practice using IVR and web based call tracking software
ACCOUNTS PAYABLE
KGiS improves payment cycle and the AP process for American assisted living and long term care facilities
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