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About Accumed

Our Commitment to Quality

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ACCUMED is committed to business excellence, including the systematic use of Quality Management principles and tools in Revenue Cycle Management and medical claims processing that improve performance and lead to enhanced customer experience. Our business excellence framework is designed to achieve Assurance, Control and Continual improvement of services provided to our clients.

We are committed to detecting, correcting and preventing fraud and abuse in insurance and medical billing, as we conduct our business ethically, with integrity and in compliance with applicable legislation and regulations.

We implement ISO International Standards aimed at building and developing more efficient and effective business practices, respecting all laws, requirements and commitments.

Assurance

Organizational Capability Group

Accreditations
  • ISO Standards (Implementation and Evaluation Management)
Perception Management
  • Best practice Management
  • Customer Satisfaction Survey
  • Taking relevant action based
    on Survey
Capabality Enhancement
  • Rules Engine
  • Knowledge Management

Compliance and Audit Group

Compliance
  • Statutory and Regulatory Compliance
  • Contractual Compliance
  • Adherence to Compliance Methodology
Audit
  • Quality Management system
  • Information Security Management
  • Internal Audit
  • Self - Assessment

Control

Quality Group

Operations Quality
  • Transaction Monitoring
  • SLA Management
Transition Quality
  • Customer Interfacing
  • Adherence to Transition Methodology
  • Transition Assessments
  • Tollgate Reviews

Improvements

Continual Improvements Group

Continual Improvements Group
  • Small Improvements/KAIZAN
  • LEAN
  • Diet Six Sigma
Training
  • Process Trainings
  • New Hire Trainings
  • Client Trainings
  • Training on Quality Concepts
We also have a robust Quality Management system, which identifies and catches errors before claims are delivered to the payer for processing.

Our statistically driven review methods ensure that we cover all aspects of work produced by operations, while our quality performance is benchmarked against the highest level of industry accuracy thresholds.

AccuMed’s gap analysis and recommendations through this system not only helps our internal teams and external clients increase their process efficiencies, but also reduce non-conformities and proactively identify risk areas.

Following is our quality management process:
Quality Management System
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Claims worked by an RCM unit
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Sample pulled for review
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Check action taken
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QA feedback provided
All errors sent back to the staff
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Correct actions tagged appropriately on the Quality tool
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Accuracy score calculated weekly/montlhy based on all errors
  • Icon setting green Claims worked by an RCM unit
  • Icon for label green Sample pulled for review
  • Icon check green Check action taken
  • Icon for message green QA feedback provided
  • All errors sent back to the staff
  • Icon check green Correct actions tagged appropriately on the Quality tool
  • Icon for folder Accuracy score calculated weekly/montlhy based on all errors