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Healthcare

CaseWare IDEA Applications


Here are some examples of analyses that can be performed using IDEA. Data from different systems can be brought together for complete analysis. Ultimately, you are only limited by your imagination.

Accounts Receivable, Patient Billing and Managed Care

  • Calculate average days from discharge to bill and bill to payment by payer or department
  • Determine appropriate level of contractual allowance and doubtful accounts reserves
  • Age receivables on date-of-service rather than invoice date to recalculate cash flow
  • Analyze rejected payments by financial class, procedure code, and cost centre
  • Identify underpaid managed care accounts
  • Determine profit margin by physician and financial class

Charges

  • Identify late charges by department and by month
  • Look for invalid, high dollar, or duplicate charges on patient bills
  • Look for lost charges by matching supplies used to supplies billed
  • Check procedure codes and billed charges to identify inappropriately billed charges

Clinical Subsystems

  • Compare patient visit data on clinical subsystems to patient master data
  • Identify interface failures
  • Identify pricing discrepancies between subsystems and master data

Marketing

  • Develop patient statistics by postal codes or other demographic data
  • Look for incomplete or miscoded patient demographic information
  • Identify profitable segments of the patient population

Materials Management

  • Analyze usage and ordering to improve inventory reordering
  • Report on stock and high value balances using any selection criteria
  • Identify obsolete inventory by turnover analysis
  • Compare speed and accuracy of delivery by product and vendor
  • Profile supply usage by month and by department

Medical Claims

  • Analyze timeliness of claims payments by comparing claim date, claim received date, and claim paid date
  • Look for duplicate billings and claim payments based on patient, provider, date of service and amount

Medical Records

  • Identify duplicate medical records for the same patient
  • Track diagnosis coding deficiencies and incomplete records
  • List incomplete records and incompatible coding
  • Report on procedure codes by physician, department, or patient

Specialists

  • Determine specialist/doctor contract compliance
  • Evaluate specialist/doctor practice history by patient type and payer
  • Report on incomplete specialist/doctor profiling information

Purchase Order Management

  • Report on purchasing performance by location.
  • Identify pricing and receipt quantity variations by vendor and purchase order
  • Identify duplicate purchase orders and receipts without purchase orders
  • Reconcile receipts by comparing accrued payables to received items
  • Compare vendor performance by summarizing item delivery and quality

Applications , CaseWare IDEA



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