Health Insurance companies still utilize manual coders to keep track of up to 1,00,000 ICD codes with slight exceptions and extract insights from complex medical documents. With that came the requirement of eradicating the manual medical coding error rate that normally has been recorded as 33%.
The process involves multiple chart reviews per patient and hybrid measurements require the review of medical records, thus increases the review time per patient. This seemed like an impossible challenge.
47Billion acted beyond a technology vendor for the client and deployed a HEDIS Audit management ICD Engine.
The platform was helpful for the health insurance companies and ultimately generated ROI for the client –
- Up to 150% Increase in the number of HCCs matched as compared to the manual process
- US$ 3000 compensation to an insurance company for every patient found with HCC
- Increased coding speed and improved overall coding accuracy by up to 98.2%
- Filters a higher percentage of false positives
- Reduced coding time to 20%
The use case explains how the platform helped in revolutionizing the health insurance company processes.
Download a copy of the case study to learn how they achieved the claims processing success.
/ February 27, 2023
Electronic Health Record (EHR) is a health record documenting each patient visit called to encounter, followed by supplemental documentation such... Read More
/ February 16, 2023
What is Industry 4.0? Industry 4.0 is the fourth industrial revolution! It is helping automate businesses and making processes more... Read More
/ February 3, 2023
Data as a Service (DaaS) systems store, process, integrate, or analyze mission-critical enterprise data using cloud deployments’ adaptability and limitless... Read More
/ December 23, 2022
The Importance of EHR in the Healthcare Ecosystem EHRs offer several advantages to patients and healthcare professionals. They have emerged... Read More
/ November 25, 2022
The healthcare industry is rapidly adopting Blockchain as the next best thing since sliced bread. Blockchain carries the potential to... Read More
/ November 17, 2022
A health insurance company analyses its data and discovers that a significant chunk of diabetic patients also suffers from retinopathy.... Read More
/ October 28, 2022
A Globe Newswire report by Data Bridge Market Research indicates that the Healthcare business intelligence (BI) market will grow at... Read More
/ September 13, 2022
There is rapid growth in the aging population worldwide, specifically in the growing economies of Europe, Japan, and China. Statistics... Read More
/ March 30, 2022
How can a health insurance company gain a strategic advantage by measuring, analyzing, and acting upon quality measures to keep... Read More
/ August 25, 2021
The pandemic second wave started; James received his positive report. He checked bed and oxygen availability over a hospital infrastructure... Read More
/ August 26, 2020
Healthcare is more about forecasting and reducing risk, based on current and historical patient data. For instance, if we consider... Read More
/ June 18, 2020
A 60-year-old patient walks into a new medical facility. He carries with him a big pile of printed papers of... Read More
/ March 20, 2020
World Population Prospects predicted that by 2050 1 in 6 people in the world will be over the age of... Read More
/ August 27, 2019
9.6 million Deaths were reported in 2018 due to cancer. It has become a great scourge of our time. The... Read More