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At Niha we have implemented an internal quality analysis process in order to maintain and exceed industry standards for quality across all of our operations. Approximately fifteen percent of our cases undergo this review annually by teams of both US and international Niha employees.
We have attained our quality objectives by benchmarking and setting new standards for quality control after a careful review and consideration of current quality standards. Our goal in doing this is to continue to improve our overall performance and to add value to our clients’ businesses by maintaining excellent customer experiences.
Below is a brief overview of Niha’s unique 3-phase approach to quality analysis. This process is performed within a 24-hour turn around time for each case.
3-Phase Approach to Quality Analysis ::-
- Phase 1:
- Case review by senior coders and team leads.
- This includes any and every case our front-line coders are not confident with.
- Phase 2:
- Full review by QA team.
- This involves every case the coding teams have identified questions on, including those in Phase 1.
- Phase 3:Random QA.
- CMS approved RAC issues
- OIG workplan topics
- Historical areas of concern
The random selection of cases utilizing our internal focus target lists developed from: