thynk

AI-Based Rule Engine that
results in cleaner claims

thynk

Why Thynk

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 violation in real time at each touch point of the patient’s journey.

Why THYNK icon for Patient Eligibility & Pre Approval Checks

Patient Eligibility &
Pre Approval Checks

Why THYNK icon for KSA Regulatory Standards for NPHIES, ICD10 AM, ACHI, Saudi Billing System (SBS)

KSA Regulatory Standards for
NPHIES, ICD10 AM, ACHI,
Saudi Billing System (SBS)

Why THYNK icon for Supports ICD10 CM, CPT (v. 2018 & 2022) standards in the UAE

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

Why THYNK icon for HIS integration covering al RCM touch point across the patient journey

HIS integration covering al RCM
touch point across the patient journey

Why THYNK icon for Medical Necessity & Documentation Checks

Medical Necessity &
Documentation Checks

Why THYNK icon for HIS integration covering al RCM touch point across the patient journey

HIS integration covering al RCM
touch point across the patient journey

  • User friendly, Easy to Set up
  • Highlights Revenue Leakage Granulary
  • Provides Breakdown of Denials’ Activity Category Wise
THYNK Dashboard 3 showing Download-able Results in Both PDF & Excel Formats Layer
  • Breaks Down Rejections Severity Wise
  • Provides a Quick Glance on Overall Claim Health
  • Highlights the Issues & Advises Resolutions
THYNK Dashboard 2 showing Breaks Down Rejections Severity Wise Layer
  • Download-able Results in Both PDF & Excel Formats
THYNK dashboard shows User friendly and Easy to Set up Layer
  • User friendly, Easy to Set up
  • Highlights Revenue Leakage Granulary
  • Provides Breakdown of Denials’ Activity Category Wise
THYNK Dashboard 3 showing Download-able Results in Both PDF & Excel Formats
  • Breaks Down Rejections Severity Wise
  • Provides a Quick Glance on Overall Claim Health
  • Highlights the Issues & Advises Resolutions
THYNK Dashboard 2 showing Breaks Down Rejections Severity Wise
  • Download-able Results in Both PDF & Excel Formats
THYNK dashboard shows User friendly and Easy to Set up

FEATURES & BENEFITS

Our Rule Content Includes & Supports

PLANS & PACKAGES

All our solutions are based on flexible pricing
plans to suit a wide variety of business needs

LISENCING OPTIONS

thynk-packages-check

On Premise
Annual Licensing

thynk-packages-check

Cloud monthly
Subscription

thynk-packages-check

Monthly Per
claim transaction

thynk
SaaS
ENTERPRISE
Rule Edits Content

Read More>

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

Read More>

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

Read More>

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

Read More>

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

Read More>

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

ENTERPRISE

  • Rule Edits Content Read More >

  • 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

  • Rule Edits Content Read More >

  • 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 Read More >

  • 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 Read More >

  • 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 Read More >

  • 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 Read More >

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