هو محرك لقواعد الأعمال قائم على الذكاء
الاصطناعي يؤدي إلى مطالبات أكثر تنقية

Why Thynk

لماذا تختار ثينك

THYNK is a fully integrated AI-based real-time rules edit engine that supports medical billing processes for immediate tangible financial value. It detects policy violations in real-time at each touchpoint of the patient’s journey.

Patient Eligibility & <br />Pre Approval Checks

Patient Eligibility & <br />Pre Approval Checks

KSA Regulatory Standards for <br />NPHIES, ICD10 AM, ACHI, <br />Saudi Billing System (SBS)

KSA Regulatory Standards for <br />NPHIES, ICD10 AM, ACHI, <br />Saudi Billing System (SBS)

Supports ICD10 CM, CPT <br />(v. 2018 & 2022) standards <br />in the UAE

Supports ICD10 CM, CPT <br />(v. 2018 & 2022) standards <br />in the UAE

HIS integration covering al RCM <br />touch point across the patient journey

HIS integration covering al RCM <br />touch point across the patient journey

Medical Necessity & <br />Documentation Checks

Medical Necessity & <br />Documentation Checks

HIS integration covering al RCM <br />touch point across the patient journey

HIS integration covering al RCM <br />touch point across the patient journey

  • User friendly, Easy to Set up
  • Highlights Revenue Leakage Granulary
  • Provides Breakdown of Denials’ Activity Category Wise
  • Breaks Down Rejections Severity Wise
  • Provides a Quick Glance on Overall Claim Health
  • Highlights the Issues & Advises Resolutions
  • Download-able Results in Both PDF & Excel Formats
  • User friendly, Easy to Set up
  • Highlights Revenue Leakage Granulary
  • Provides Breakdown of Denials’ Activity Category Wise
  • Breaks Down Rejections Severity Wise
  • Provides a Quick Glance on Overall Claim Health
  • Highlights the Issues & Advises Resolutions
  • Download-able Results in Both PDF & Excel Formats

FEATURES & BENEFITS

الميزات والفوائد

يتضمن محتوى القواعد لدينا ويدعم

PLANS & PACKAGES

الخطط والحزم

تعتمد جميع حلولنا على خطط تسعير مرنة
لتناسب مجموعة متنوعة من احتياجات العمل

خيارات الترخيص

On Premise Annual Licensing

ترخيص سنوي محلي ضمن
مقر العميل / المستشفى

Cloud Monthly Subscription

Cloud Monthly
في الخدمة السحابية

Monthly Per Claim Transaction

رخصة شهرية لكل معاملة
Claim Transaction

Thynk Full Logo
اشتراك البرمجيات كخدمة
للمؤسسات
Rule Edits Content

اقرأ المزيد>

THYNK has over 4 Million business rules logic (rule edits) to detect and report errors and gaps that may exist in the medical claim
based on the regulatory and payer rules, policies and circulars from major regional regulatory bodies such as:
– Corporate Council for Health Insurance (CHI)- KSA
– Department of Health (DoH)- Abu Dhabi
– Dubai Health Authority (DHA)- Dubai
– Riayati– Northern Emirates

 

The rules reviews are based on:
– Claim mandatory data elements. Forming the minimal required data set to perform a claim scrubbing rules edits validation.
– Claim optional data elements. To enhance the accuracy and comprehensiveness of rule edits validations.
– Members Insurance Details, such as patient policy particulars.
– Payer Contract and Pricing based rules.
– Patient Demographics, such as age, gender …etc.
– Patient claims/encounters history.

 

• Core Crosswalks:
– International Crosswalks (CPT-ICD10CM and ACHI/ICD10AM)
– Local Crosswalks Localized UAE and KSA market crosswalks – based on payers/regulator guidelines.

• Extended Crosswalks:
Offering a wider scope extending on core MNEC Crosswalks and will include the following:
– National Correct Coding Initiative Edits (NCCI)
– Medically Unlikely Edits (MUEs)
– Principle Diagnosis Selection (PDx)
– Etiology/Manifestation coding
– Drugs-ICD Crosswalks: Local market Rule Edits
– Gender-ICD Crosswalks. International reference
– Gender-CPT crosswalks: International reference
– Age-CPT crosswalks: International reference
– Maternity-CPT crosswalks: International reference
– Laboratory Panel Coding
– Infusion/injection Coding

Age & Gender
Contract Management Checks
Medical Coding & Medical Necessity
Payer & Billing
Pre-Authorization Rules
Price and Patient Share Checks
Provider Custom Rules

اقرأ المزيد>

Support for developing business custom rules content managed by a team of expert rule and market expert teams to support
your RCM automation and specific review and validation needs.

Analytics & Dashboards

اقرأ المزيد>

Provides a comprehensive and visualized dashboards as well as tabular representation to help discovering areas for improvements and make your team prepared to act proactively on RCM related issues.

Predictive Analytics & AI
Machine Learning Models

اقرأ المزيد>

Advanced Machine Learning (ML) models covering:
a. Historical claims denial and payment patterns and prediction of future denial risk.
b. Denials not covered by rules and propose suggested rules to cover denials risk.

HIS Integration Engine

اقرأ المزيد>

THYNK provide an API and an integration engine that supports HL7 and Webservices capability to streamline the integration with current HIS solution.