Say this first: all data is synthetic — no real patients, no real hospital, no real insurer. Every baht on this page comes from the assumptions table at the bottom; your hospital replaces them with its own numbers and the method stays the same.
Revenue Integrity — money we earned but never billed
Owner, Director, CFO, head nurse ICU/OR. The care was delivered and documented. The bill does not show it.
Quick Sight Q&ASpace (chart vs bill)encounters · charge-leakage-linesdocs 14, 15, 16, 22~7 min
Open the dashboard KPI: identified leakage this quarter 4.03M THB (2.98M unbilled items + 1.05M under-coded severity) on 137.71M gross.
Ask the questions below. The night-shift gap is the moment the head nurse leans forward.
Switch to the Space. Paste the Space question for discharge summary 14. Quick reads the chart and lists every billable item with its time; compare with the leakage lines for IP690455.
How much documented-but-unbilled charge and coding gap did we have this quarter, by department?Expect: Total 4.03M; top: Orthopedics & Trauma 1.35M, ICU 1.09M, Surgery 892,550
Compare the share of admissions with unbilled items by admitting shiftExpect: Night 65% vs Day 38% / Evening 36%
What are the top 10 unbilled items by THB and the main reason?Expect: Reason 'Not entered' = 44% of leakage THB
(Space) From discharge summary RWW-DS-2569-08-22-0455, list every procedure, drug, supply and consult with time and quantity, and map each to an item code in RWW-FIN-SOP-020.Expect: A-line, FAST, blood warmer x2, TXA, critical-care consult → 12,650 THB unbilled on this one case
(Space) Does the narrative of RWW-DS-2569-09-02-0558 support a more specific principal diagnosis than J18.9? Cite the lines.Expect: Sepsis with organ dysfunction + AKI documented; coding gap 31,500 THB — coder confirms
Wow: the operative note of one MCI patient alone shows 38,400 THB of hemostatic matrix, cell saver, CVC and TEG never billed. Multiply by 337 encounters that leak — nobody has time to read every chart; Quick does.
Recoverable if rebilled within the payer deadline (assume 70%): 2.82M THB / quarter.
2
Claim Denial Defense — the money insurers said no to
CFO, billing manager, attending physicians. Doctors hate writing appeals; the money stays on the table.
Dashboard: 117 claims denied or partially paid, 8.74M THB. 61% were never appealed = 5.52M THB, while appeals that were filed won 63%.
Ask why: two root causes carry most of it — missing pre-authorization on imaging and ICU medical necessity at one insurer.
Run the Flow with denial letter 18 (KRH, 217,500 THB, ICU days 4-6). Quick reads the op note and the insurer criteria and drafts RWW-F-052 with each ICU day mapped to a criterion and a cited line.
Stress the guardrail: the draft is labelled [Drafted by system — pending physician confirmation]. The physician signs; AI never sends.
Denied amount by payer and denial reason this quarter, and how much was never appealed?Expect: Missing pre-auth (PA-IMG) 3.70M · ICU necessity (MN-ICU) 1.80M · not appealed 5.52M
For KRH, compare the denial rate of stays with more than 3 ICU days versus 3 or fewerExpect: 60% vs 26% — a documentation pattern, fixable
(Space) What must a daily ICU note contain to meet KRH medical-necessity criteria? Cite RWW-FIN-REF-003.Expect: 6 criteria listed with clause numbers
(Space) Draft an appeal for claim CL88486 using form RWW-F-052, citing operative note RWW-OP-2569-09-06-0672 for each ICU day. Label it pending physician confirmation.Expect: Use this in the Space if the Flow is not built
Wow: the appeal a surgeon would spend 40 minutes writing appears in about a minute, with ventilator, norepinephrine, lactate 6.8 and open abdomen cited per day. 217,500 THB goes back into the queue instead of being written off.
Appeal the backlog at the observed win rate (63%): 3.48M THB / quarter. Fixing pre-auth prevents the largest bucket next quarter.
3
Capacity = Revenue — every patient who walks out or gets transferred
ER director, nursing director, COO. The same ER charts as before, but the Y-axis is now baht.
Quick Sight Q&Aer-visits (+revenue) · bed-census-hourly · er-shift-staffingAutomate~5 min
Dashboard: revenue lost to capacity this quarter 4.75M THB = 136 patients who left without being seen (1.49M) + transfers out (3.26M).
Ask the ICU-full week question: 10-14 Aug cost 484,470 THB in transfers, 2.7x a normal 5-day period. That is the business case for surge beds.
Clinical bonus (if doctors are in the room): run the Referral → Pre-Arrival Flow with letter 08 — activation level and blood prep drafted in 60 seconds with SOP clauses.
Lost revenue from LWBS and transfers out by week, with ICU beds availableExpect: Peak week of 10 Aug; ICU available 0-1
Is LWBS rate related to physicians on duty? Show lost revenue by shiftExpect: July weekend nights with 1 physician run about twice the LWBS rate
Compare median door-to-CT of trauma cases by shift and day of weekExpect: Weekend night ≈ 58 min vs ≈ 44 weekday
Wow: the director asks one question in plain Thai and gets the cost of an ICU-full week in baht. Automate turns it into a morning alert to the bed manager, before the money leaves.
Recover 30% through surge planning and fast-track staffing: 1.43M THB / quarter.
4
Patient Retention — patients who should have come back
Director, clinic heads, marketing, nurse coordinators. Safety first, then continuity, then revenue — that order is why doctors say yes.
Quick Sight Q&AAutomate weeklySpace (SOP 21)patient-recall~5 min
Dashboard: 1,245 patients overdue, 646 never contacted, 5.09M THB expected revenue at risk (check-up packages 2.36M).
Open with safety, not sales: 44 overdue patients have an abnormal result waiting and nobody has called them.
Show the weekly Automate run: recall list by priority (SOP RWW-QM-SOP-012) + LINE/SMS drafts with no clinical detail, approved by the nurse coordinator before sending.
Overdue patients never contacted, and revenue at risk, by cohortExpect: Check-up packages are the largest bucket (2.36M)
Which overdue patients have an abnormal result pending and have not been contacted? Group by attending physicianExpect: 44 patients — priority 1 per SOP, call within 2 working days
(Space) Draft the LINE message for a priority-3 lapsed check-up patient per RWW-QM-SOP-012, with placeholdersExpect: No clinical detail; consent + do-not-contact respected
Wow: the same list that brings back 2.36M THB of check-ups also finds 44 people with abnormal results nobody followed up. Revenue and patient safety in one query.
At the return rate already observed when patients are contacted (55%): 2.80M THB / quarter.
★
Finale — the owner's board brief in one prompt
Quick DesktopPPTX~3 min
In Quick Desktop attach encounters.csv, claims-denials.csv, patient-recall.csv and revenue-assumptions.csv, then run the prompt below. Open the PPTX in PowerPoint.
Create a 6-slide board brief in PowerPoint for the hospital owner: 1) revenue opportunity this quarter by the four levers (charge leakage, denials not appealed, capacity loss, patient recall) with identified and realistically recoverable THB; 2) top 3 departments by leakage; 3) denial root causes and the pre-authorization fix; 4) ICU-full week cost; 5) recall list with the safety angle first; 6) a 90-day action plan with owners. State every assumption from revenue-assumptions.csv on the slide it is used. No patient names. Slide titles in Thai and English.Expect: 6 slides, 1-3 minutes; numbers match the dashboard
Say it right: Quick Desktop scheduled tasks run on the user's computer (machine and app must be on). Server-side scheduling is Quick Automate.
S
Skills — the hospital's way of working, written once
Quick DesktopSKILL.mdskills/dist/*.zip~3 min
A Skill packages instructions + the hospital's own SOPs so anyone gets the same, auditable result. Install the 5 zips from skills/dist/ in Quick Desktop (Customize → Skills → Create → From file). Show one live, then say: "every nurse auditor now works to the same checklist".
Skill
Scene
Demo input → result
chart-to-bill-audit
1
Discharge summary 14 + itemized bill → 12,650 THB unbilled, each item with code and evidence line
coding-completeness-check
1
Discharge summary 16 → sepsis + AKI documented but coded J18.9 → physician query (gap 31,500 THB)
denial-appeal-drafter
2
Denial 18 + op note 15 → RWW-F-052 for 217,500 THB with deadline
This week's overdue list → P1 calls first, PDPA-safe LINE/SMS drafts
Use chart-to-bill-audit to review this encounter: list every documented item that is missing or under-billed, with item code, evidence and THB value.Expect: Attach 14 + itemized-bill-IP690455.csv → 5 items, 12,650 THB
Assumptions behind every baht
key
Value
Meaning
er_visit_net_esi1
32,000 THB/visit
Net revenue, ED visit ESI 1 (before admission charges)
er_visit_net_esi2
12,500 THB/visit
Net revenue, ED visit ESI 2
er_visit_net_esi3
5,600 THB/visit
Net revenue, ED visit ESI 3
er_visit_net_esi4
2,900 THB/visit
Net revenue, ED visit ESI 4
er_visit_net_esi5
1,800 THB/visit
Net revenue, ED visit ESI 5
ward_bed_day_net
18,500 THB/bed-day
Net revenue per general ward bed-day
icu_bed_day_net
58,000 THB/bed-day
Net revenue per ICU bed-day
admit_conversion_lwbs
0.12 ratio
Share of LWBS patients who would have been admitted
No. Synthetic data for a fictional 30-bed ED hospital. Every THB figure is derived from the assumptions table on this page, which the hospital replaces with its own numbers — the method stays the same.
Will AI bill or appeal automatically?
No. It produces a candidate list and drafts. A coder or nurse auditor confirms every rebill; the attending physician signs every appeal. RWW-FIN-SOP-020 and RWW-F-052 are written that way.
Where does patient data live?
In the hospital's own AWS account. Quick Sight reads a governed replica or curated extract with row-level security, never the live HIS or billing database.
PDPA for recall messages?
Only consented patients, do-not-contact list respected, no clinical detail in LINE/SMS, identity verified before discussing results. Legal review is the hospital's call; AWS provides the controls.
Does this replace the HIS or revenue-cycle system?
No. It sits beside them: reads documents, compares, drafts and alerts. The HIS and billing system remain the system of record.
Presenter-only page. Generated by scripts/build_presenter.py from analytics/*.csv. The previous ER-operations version is kept at presenter/index-v1-er-ops.html.