Fundamental Problems
- Lack standardization in reference manuals
- Claim downloads batched daily
- Import of reports non-standardized and a manual process
- Claim rejection list backlog
- Hospital and clinic registrations different
- Documentation requirements extensive
- Processes isolated from one another
- Claim submission batched and backlogged
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Solutions
- Standardized work areas
- Accelerated second claim download
- Scripting of claims/remittance information
- Focus on backlog
- Consolidated hospital and clinic registration
- Documentation improved and standardized
- Health Information Management coding organized for one piece flow
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