Business Intelligence

The management of information within healthcare has always been a top priority - it drives payment by results after all!

Turning that information into knowledge that can be used to drive efficiencies is the next step in the evolution of data.

At The Thinking People Group we strive to ensure that health and social care organisations are fully equipped with the skills, techniques and, as importantly, the tools they need to manage and derive business intelligence from their information effectively with as few FTEs as possible.

One such tool is our  Payment Challenge ApplicationTM - used to collate and analyse Inpatient, Outpatient and A&E data sets to highlight anomalies around payment claims by checking, among other things:

  • Multiple Inpatient procedures on the same day, one day apart, two days apart, fourteen days apart and twenty eight days apart of each other for the same patient.
  • Multiple Inpatient procedures with the admission dates falling before the discharge date of the previous Inpatient procedure for the same patient (overlapping dates).
  • Multiple Inpatient procedures within the same day to fourteen days apart of each other for the same patient for A&E admissions only where the A&E attendance falls after the Inpatient admission.
  • Multiple Outpatient Consultant to Consultant referrals in different specialties for first attendances only.
  • Inpatient procedures with an Outpatient procedure match for the same patient with the same attendance data and the same speciality.
  • Inpatient procedures with an Outpatient procedure match falling between the admission dates and discharge dates of the Inpatient procedure for the same patient with the same attendance date and the same specialty.
  • Duplicate Outpatient attendances for the same patient, the same attendance date and the same specialty.
  • Multiple first attendances in a consecutive six month period for the same patient, same specialty.
  • A&E and Outpatient match occuring on the same day for the same patient, 

And many more. These checks can produce reports within 2-3 hours of the CDS SUS data becoming available and have saved PCTs litterally MILLIONS of pounds in overperformance payments during the 5 day challenge window.

For a FREE one-month trial of the Payment Challenge ApplicationTM contact us now.