LEAN SIX SIGMA APPLICATION IN HEALTHCARE PROCESSES Neha Ahlawat : Consultant Doyal Saha- Consultant Deloitte Consulting India Pvt. Ltd

Abstract   Use of lean framework in healthcare domain is relatively new and using Lean techniques in complex healthcare process such as claims processing will help in increasing efficiencies. The purpose of this paper is to present Lean Six Sigma methodologies for improving process throughput and quality mainly claims.

Lean Six Sigma Practices : Claims Processing   Identify clear output specifications Establish the structure and eligibility of claims Lenience of the specification or targets Improve the outcomes of processes Reconcile and report claims

Design/methodology/Approach Base Level: DMAIC (Define, Measure, Analyze, Improve and Control) Lean Six Sigma Framework Top Level: Define Measure and Analyze Middle Level: Governance teams

3 Tier approach in Claims   3 Tier approach in Claims

Define Measure Analyze Improve Control   DMAIC Approach Define Measure Analyze Improve Control

Cited References References & Appendix www.ncqa.org/information-on-health-planshttp: www.healthcarefinancenews.com/resource-central http://www.marshclearsight.com/root-out-waste-claims-process/ https://goleansixsigma.com/lean-six-sigma-success-stories-in-the-healthcare-and-medical-industries/   Other References – http://www.firstsourcehealthcare.com/claims-processing-and-adjudication-services/#ADJUDICATION

Neha Ahlawat Doyal Saha Author Biography B school graduate from Symbiosis- Pune who recently joined Deloitte as an Consultant. Deloitte's Maverick Campus Program provided me an opportunity to be part of this organization where unconventional thinking is nurtured. Currently I am working in Anthem with CS90 traditional team. Doyal Saha With Deloitte, I started as a MBA summer intern. My project involved the requirement analysis of Public Human & Healthcare systems in various states of USA. It also involved Project Management activities for resource allocation optimization. I have a Green Belt in Lean Six Sigma

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