Business Intelligence Enables Improved Revenue Management And Coding Quality
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. Working closely with the client, our team identified three key steps to improve coding quality; establish a unified database and an automated business intelligence solution that would enable high-performance data analysis across the different parts of the organization. Design and validate medical rules for the identification of likely cases of incomplete coding, based on historical coding data. For example, the system contained rules for what to do when a certain drug is prescribed, but there is no coding of a corresponding disease. Also prepare and execute quarterly campaigns to identify and reach out to physicians with higher levels of inaccurate coding.