40-year-old multi-specialty improves patient satisfaction and claims revenue turnover using GlanceClaim™
Total Claims Processed
> 1.7K per month
Average inappropriate services caught
> 2.3K per month
Average $ saved
Total services analyzed
> 10K per month
A small healthcare provider situated in the eastern part of Riyadh. They serve a small population who remain loyal to their doctors. Insurance revenue represents a large part of the clinic's revenue. Unfortunately, the team responsible for claim preparation did not have the experience needed to create high-quality claims. GlanceClaim™ helped the provider reduce their rejections which allowed the provider to continue serving their population.
The clinic had a strong workforce of 17 doctors however the team was not equipped to accurately prepare over 10K claims a month which resulted in several issues with claim documentation and coding.
The clinic needed an innovative solution that could help their staff greatly reduce errors on claim forms prepared by their staff as well as ensure smooth processing of claims by the insurance company.
GlanceClaim’s actionable and easy-to-use claim checker and coding support tools were introduced to the medical billing and clinical team. With the help of GlanceClaim™ tools, the account was able to automate several tasks in their workflow and was able to check their claims for
Medical policy compliance
NPHIES data incompatibility
Coding standards compliance
Medical necessity, indication, and PBM compliance.
Compliance with the regulatory policies.
Additionally, GlanceClaim™ systems supported the center’s executive team with deep analytical reports for better understanding, root analysis, and decision-making support.
Using GlanceClaim™, the billing staff was able to resolve over 2.3K claim errors as well as improve the quality of documentation as well as management of claims. They could also perform an in-depth analysis and evaluate multiple operational and business areas, including their technical and operations infrastructure. GlanceClaim™’s multi-stakeholder support enabled the clinic to lower its claim rejection rates significantly and improve reimbursement rates by 44%
Using GlanceClaim™, the medical center was able to
Reduce their claim rejection/denial rates
Reduce their preauthorization rejections
Increase the utilization of their medical services
Improve their medical documentation quality
Improve claim submission speed
What is GlanceClaim™?
GlanceClaim™ is an advanced medical claim auditing and documentation/decision support system designed to improve claim integrity and quality, and workflow for healthcare providers. As Saudi Arabia’s first in-house medical claim expert system that supports digital ICD-10 coding and documentation, and clinical decision-making, GlanceClaim™ is uniquely positioned to solve various occurrences of technical and medical documentation errors on claims
Facing challenges with insurance rejections and payouts? We would love to help!