How SmartHealth Used GoMeds Analytics to Identify INR 1.2 Crore in Revenue Leakage

SmartHealth Hospital Group operated two facilities in Kochi -- a 150-bed multi-specialty hospital in Edappally and an 80-bed general hospital in Kakkanad. Despite being under the same ownership, each hospital operated independently with separate HMS platforms, different reporting formats, and no unified analytics.

The Group CEO, Dr. Thomas Varghese, knew money was leaking but could not quantify where. Each hospital reported revenue figures in different formats, making comparison impossible. The finance team spent 5 days at month-end compiling consolidated reports that were always questioned for accuracy.

Revenue leakage was suspected but invisible. Procedures were performed but not always charged to the patient (especially emergency procedures during odd hours). Insurance claims were submitted late, resulting in rejections and delayed settlements. Inventory wastage across both hospitals was tracked only during the annual stock audit.

Dr. Thomas had invested INR 30 lakh in a generic BI tool two years earlier, but the implementation failed because the tool required extensive customisation for healthcare metrics, and the vendor did not understand hospital workflows.

GoMeds AI deployed its Healthcare Analytics Platform connecting data from both hospitals' HMS systems into a unified analytics dashboard.

The revenue leakage analysis was the first major insight. By comparing billing data against clinical records (procedures performed, investigations ordered, consumables issued), GoMeds identified INR 1.2 crore in annual leakage: INR 65 lakh from unbilled procedures (primarily emergency and ICU charges), INR 35 lakh from delayed insurance claims that resulted in rejections, and INR 20 lakh from inventory wastage that was not being tracked.

A unified dashboard gave Dr. Thomas real-time visibility into both hospitals for the first time -- revenue, occupancy, patient volume, department performance, and financial KPIs on a single screen. Departmental benchmarking compared performance between the same departments at both hospitals, identifying best practices at one that could be replicated at the other.

Insurance analytics tracked every claim from submission to settlement, flagging delays and rejections with root cause analysis. The average claim settlement cycle improved from 75 days to 52 days.