Page 10 - C.Journal 3rd edition

Claims Journal 3rd Edition Claims Journal 3rd Edition

QC Report Of Dec / Jan

• Quality index for January is 90.7% . Compared by last December 2016 , it was 92.3.

• The most frequent error area found is the “wrong ICD/benefit head selected “, which is 24.35% of the total errors.

• On the other hand errors like “Approving service has no indication / irrelevant to condition” is frequently repeated with 20.36% of the total errors.

• As we all know these are fatal mistakes that we must avoid. We have to check the entire episode of care before adjudication the claim.

Good luck

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