Business Intelligence Enables Improved Revenue Management And Coding Quality
Enhanced IT capability brings business insights and boosts revenue by $150 million a year. clients pay depending on how accurately the health care provider encodes the diagnosis and treatment of their patients. Discoveries find client was managing more than 2 billion sets of claims and patient data, but it was not able to combine data effectively to identify instances of incomplete ICD ( International Statistical Classification of Diseases ) coding. McKinsey proposed applying a business intelligence solution to identify insufficient coding for selected chronic diseases and to identify individual providers with below-average coding quality. Then the team works with the client to identify three main steps to improve the quality of the coding : establish a unified database and an automated business intelligence. Design and validate medical rules for the identification of likely cases of incomplete coding based on historical coding data. Prepare and execute quarterly campaigns to identify and reach out to physicians with higher levels of inaccurate coding. Because of the new process clients get additional income of more than $ 150 million per year. The enhanced IT capability now enables our client to gain valuable insight from high-performance data analysis across the whole organization.