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Magnifier Audit Tool

What is Magnifier Audit Tool?


Magnifier Audit Tool is the most unique and advanced Healthcare Claims Audit tool in MENA Region providing accurate capturing of all the elements needed to specifically see the root cause of RCM challenges in any healthcare facilities, insurance companies and other health organization. It assists in providing precise solutions in compliance to the UAE market standards, needs and requirements.

Features:

  • Computer Assisted Auditing
  • Captures all the clinical coding added, revised and deleted codes for accuracy and error calculations
  • Provides accurate IR-DRG accuracy and error rates
  • Integrated IR-DRG weights calibrated per DHA and DOH standards
  • Auditor Friendly Audit Sheets
  • IR-DRG Calculation Tool
  • Outliers, Add on Payment (per high cost technology and consumables) capability
  • Provides Case Mix Index (CMI) accuracy
  • Computes Financial Implications per Audit Review
  • Query Management and Query Type Analysis
  • Identify the Average Length of stay GAP for the DRG and Resource utilized to render the patient care
  • Audit Trail Monitoring
  • Comprehensive Reporting Dashboard
  • Communication Email Notification Capability
  • Easily exports data to Excel spreadsheets and PowerPoint presentations

Who needs Magnifier Audit Tool?

  • Any healthcare providers for both Private and Public sectors, insurance companies and other health organization within UAE.

When is Magnifier Audit Tool required?

  • It is required all the time because it enables the providers, insurance and other health organization identify the actual gaps happening within the organization which is needed to appropriately provide solutions for improvement.

Why Magnifier Audit Tool is required?

  • Evaluate the accuracy and completeness of submitted claims by identifying the impactful leakages and gaps.
  • It helps identify and correct errors areas before insurance or government payers challenge inappropriate claims processing and medical coding.
  • It ensures an effective, efficient, and financially sustainable healthcare system
  • IR-DRG and CMI Revenue Integrity Optimization
  • Protect against fraudulent claims and billing activity
  • Increases Quality of healthcare
  • Reduction of Improper Practices and Payments
  • Provides Relevance to Education and Alarm for Compliance