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Image by Dan Schiumarini

Auditing

For over a decade, we provided Clinical Coding Audits for the Health Authority Abu Dhabi and completed over 4000 facility audits. 

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In fact Acorn was the first to introduce medical coding to the United Arab Emirates, and was the first company authorized to conduct audits on behalf of the Health Authority Abu Dhabi which prequalified the facility for license renewal.

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From manual to AI based Audits, Acorn led it all and is a pioneer in this field.

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Our latest proprietary FWA solution, InCompliance was built on over a decade of audit experience and is backed by scientific evidence as well as million of historical claims denial patters and irregularities. 

Our Journey

Our success and experience with Performance Analytics Solutions, AI based Risk adjustment and Modelling platforms roots back to 2009 when we implemented the DxCG Intelligence tool – Life Expectancy Tool in collaboration with Versik Health and the Health Authority in Abu Dhabi (HAAD).

 

This was an unprecedented initiative to analyze the entire claims data in real time and help manage the clinical and financial risks associated with caring for populations, with specificity at the individual level.

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The platform is the gold standard in risk adjustment and predictive modelling, DxCG Intelligence uses proprietary predictive models to turn healthcare data into risk scores for individual members. Scores correlate with the cost of their underlying illness burden. Aggregating the scores of individuals with key attributes generates group-level predictive results that can help answer critical questions about healthcare efficiency. The tool is currently the underlying analytics tool of the DOH claims portal.

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Models are grouped into three primary functional bundles—budgeting and underwriting, medical management, and performance assessment

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A groundbreaker in the early 1990s, the DxCG models in partnership with Verisk were originally developed with the U.S. Centers for Medicare & Medicaid Services (CMS) and served as the foundation for the Hierarchical Condition Category (HCC) model that CMS still uses as the foundation for risk-adjusted healthcare payments today.

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