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Technology

ACCUMED prides itself on having an RCM-focused billing platform and business processes that are specifically designed with the GCC healthcare market in mind. Based on a global best practice template, our technology has the capability to achieve both operational and financial excellence.

 

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Billing System

Our proprietary technology has the ability to seamlessly integrate with any existing hospital management system (HMS) or RCM software. It has the capability to consistently pinpoint and remove operational issues, as well as bridge billing process gaps to support providers’ move towards paperless claims.

AccuMed’s Billing System is a custom built platform, offering a comprehensive set of RCM of tools engineered to service GCC healthcare funding models in general, and the UAE market in particular. Coupled with powerful business tools, it delivers both billing accuracy and compliance in an ever-changing regulatory environment.

Boasting a Smart Rules Engine with advanced artificial intelligence, our Billing System ensures that your practice complies with:

  • Regulation Policies
  • Payer Policies
  • Medical Rules and ICD/CPT Crosswalks
  • Provider Business Rules
Reporting Services

The AccuMed Reporting Services are designed to provide answers and decision-support information to business critical functions. They offer greater transparency, efficiency and accuracy in the management and reporting of revenue cycle data.

Our advanced reporting capabilities mean data analysis and reporting tools work together towards creating value and optimising revenue for your practice. With our portfolio of business process solutions, you – our partners – gain the tools that will enable you to automate workflows, so as to simplify the charge capture process for a quick and accurate submission of reimbursements.

Our system enjoys a proven track record of not only delivering billing accuracy, but also of thoroughly monitoring the status of claims, making it convenient for you to predict cash flow and track transactions at all stages.

Our technology is one that is continuously evolving with the dynamic market and regulatory changes happening in the GCC healthcare sector.

Rules Engine

AccuMed’s Claims Scrubber and Rules Engine are used to define and enforce business rules, patient eligibility, medical necessity and insurance verification logic. Relevant to the local market and regularly updated set of algorithm, empowering your practice to monitor patterns of abuse and uncover suspicious claims, which when left undetected, could hurt a practice’s business.

It utilises proprietary technology and artificial intelligence to provide a rule-engine-based service where new rules can be authored, tested and deployed to ensure compliance with:

  • Regulation Policies
  • Payer Policies
  • Medical Rules
  • Provider Business Rules

Our Rules has local GCC insurance relevance with the power of international experience, including ICD 9/10 CM, CPT, IR DRG and patient safety protocols supporting high quality claim submissions, while reducing claim rejections.

Claim Scrubber

Our Claim Scrubber is a business rules management system designed to incorporate the Rules Engine’s sophisticated decision logic into any line-of-business application and quickly reflect underlying business rules as market conditions change.

 

Allocation System

The Allocation System provides automated operational planning, task distribution to staffs with relevant experience and performance monitoring for all RCM resources.

Claim Query Management

AccuMed’s Claim Query Management (CQM) module facilitates the communications between the operations’ back office team and the physicians, insurance and medical staff at the medical facility. This allows accurate collection of critically medical data needed for billing from source, as well as continuous on-the-job training to all users.

Eligibility Verification

Using the AccuMed online verification system, administrative staff can verify insurance particulars during patient registration and receive a real-time response with details about the patient’s insurance benefits. By verifying insurance coverage prior to each patient visit, you can increase collections and save time, while at the same time ensuring favourable patient experience for your customers.

Contracts Manager

The Contract and Price List Manager was designed to manage all client contracts, network access and price lists with payers, so as to streamline the process. It guarantees an audit track record of all price changes, contract particulars, price revision terms and renewal dates.