Automated Claims Processing

Automate claims intake: classify claim documents, read CMS-1500, UB-04 and unstructured documents, validate and route, on your own servers.

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Automated claims processing

Claims arrive as a bundle of documents: claim forms, medical bills and records, police and adjuster reports, photos, invoices and correspondence. Automated claims processing captures them, identifies each document, reads the data the claim system needs, and routes the claim, so adjusters and billing staff spend their time on decisions instead of data entry.

What can be automated

  • Intake from mail, fax, email and portals into one queue.
  • Classification: splitting a claim packet into its documents and identifying each type; see document classification.
  • Extraction: claim and policy numbers, claimant details, dates of service, codes and amounts. Standard forms such as the CMS-1500 and UB-04 have fixed layouts that template OCR reads quickly; letters and reports need AI.
  • Validation against policy and member data, and routing of exceptions to a person.
  • Filing each document to the claim in your claims or document management system.

Claims processing with SimpleIndex

SimpleIndex combines zone OCR for standard claim forms with its optional AI for everything else, checks values against your database, and delivers documents and data to your claims system. It runs on your own servers, and so can its AI, so protected health and personal information stays inside your network; see HIPAA compliance. For high volumes with verification stations, ABBYY FlexiCapture is the enterprise option.

Send us a sample claim packet and we'll show you the results. Ask us or call 865-637-8986.

Related

Patient intake and document management  -  AI document processing  -  On-premise AI

Not sure which software fits your documents?

Tell us about your documents and workflow, and we will recommend the right software and set up a demo or quote.

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Fixed Form Only version of ABBYY FlexiCapture is no longer available. This record has been retained for maintenance and order history. Click Here for the current listing.

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ABBYY FlexiCapture is a powerful data capture and document processing solution from a world-leading technology vendor. It is designed to transform streams of documents of any structure and complexity into business-ready data. And its award-winning recognition technologies, automatic document classification, plus a highly scalable and customizable architecture, mean that it can help companies and organizations of any size to streamline
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for invoices
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for invoices
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  • ABBYY FlexiCapture for Invoices is based on the powerful ABBYY FlexiCapture platform and includes additional functionality, pre-defined settings, validation rules, advanced database look-up and UI enhancements specifically tailored for processing invoices.
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for invoices
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