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Automating data entry from health care claims forms (CMS/HCFA 1500 and UB04) and explanation of benefits (EOB) with advanced OCR/ICR technology.
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Claims Processing Automation


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ICR forms processing software
Automating Data Entry from EOBs, HCFA/CMS 1500 and UB04 Forms

What is Claims Processing Automation?

What is Claims Processing Automation Software?

Claims Processing Automation Software is able to read the text from EOBs, CMS 1500 (formerly HCFA 1500) and soon CMS 1450 forms, and UB-04 (formerly UB-92) documents, then upload the information directly to your claims processing system. This greatly reduces the expensive data entry costs incurred by organizations that process these forms.

These systems use Optical Character Recognition (OCR) to recognize machine printed data from scanned images, as well as Intelligent Character Recognition (ICR) that can read hand printed data.

Who can benefit from Claims Processing Automation?

Who can benefit from Claims Processing Automation?

Any organization that enters data from health care claim forms and EOBs can benefit greatly from automating the process with Forms Processing Software. If you have more than 1/3 of a full time employee's time dedicated to this task you can save money with a recognition solution.

Besides the savings in time and labor, recognition systems provide a superior data entry interface that helps reduce errors. They also decrease the overall time it takes to process claims, ensuring faster payments.

How much do Claims Processing Automation systems cost?

How much do Claims Processing Automation systems cost?

There are some solutions that are higly customized and integrated, but these are cost prohibitive for all but the largest companies. ScanStore has developed solutions for automating CMS 1500 and UB-04 forms using the affordable ABBYY FlexiCapture data capture solution that gives you the same data entry automation at a much lower cost.

The total cost of a Claims Processing Automation solution includes several items:

  • Cost of the software
  • Time to install and configure the software
  • Integrate validation checks with claims software to ensure data like claimant, procedure code, diagnostic code, facility, etc. exist and are valid
  • Integrate data export with claims software
  • User and administrator training
  • Labor required to verify recognition results
  • IT infrastructure and maintenance costs

If you are processing Explanation of Benefits (EOB) files, there is additional configuration time required to adjust the baseline recognition template to read the specific formats of your commonly used insurance providers.

If you have an IT staff that is familiar with document scanning and OCR applications, it is possible to do much of the configuration and maintenance in-house. If not then it is highly recommended that you use our Consulting Services to guide you through the setup process.

But you just want to know the price, right? The total cost for software, hardware, and consulting for a typical implementation starts at about $15,000. If that sounds like a lot of money then you either don't process a lot of claims forms or haven't calculated all the costs associated with manual data entry!

Contact Us to get a professional analysis of your project requirements and a full time and cost estimate.

What is the typical Claims Processing Automation workflow?

What is the typical Claims Processing Automation workflow?

There are several steps involved in the process of scanning and recognizing claim forms data. Here is how it works in day to day operation:

  • Paper prepped for scanning (unfolded, staples removed, etc.)
  • Forms are scanned on a high-speed document scanner
  • Data on the scanned forms is recognized with Intelligent Character Recognition (ICR)
  • Recognized data is assigned a "confidence" value according to the recognition quality
  • Data fields considered "low confidence" are presented to users for manual review and correction
  • Once all errors are corrected, data is exported directly to your claims processing database, or to an XML data file that can be imported automatically.

The key thing is that the hardest part, typing in all the data from the forms, is now an automated step. This manual step is replaced by scanning and reviewing the recognized data. Roughly 5% of the data will be presented for review (up to 10% for hand-printed forms) and most of the reviewed data will not require corrections. This means the total time for the new workflow is less than half of the time it takes for manual data entry.

ScanStore’s FlexiCapture Solution for Medical Claims
UB04, HCFA1500, CMS1500, CMS1450

FlexiCapture for Claims by ScanStore

A Proven Solution – designed to increase the speed and accuracy of claims processing while reducing your processing costs

ABBYY FlexiCapture 12 is a powerful data capture and document processing software that works to convert documents into accurate business-ready data. The FlexiCapture for Claims solution takes advantage of ABBYY’s award-winning recognition technologies that deliver unprecedented accuracy in the capture of data from paper forms. ScanStore’s custom configuration of the FlexiCapture 10 system optimizes the processing of CMS and HCFA 1500, UB04, and soon-to-be-released CMS 1450.

Proven Provider

ScanStore is certified value-added reseller (VAR) of the FlexiCapture system. With over a decade of FlexiCapture experience and hundreds of unique customer engagements, we found ourselves with a prime opportunity to create a solution fitted to the specific needs of medical claims processors, but still broad enough to offer affordability, fast implementation, and rapid ROI. Processing times and costs go down while accuracy and productivity go up.

Solution Flow

The FlexiCapture for Claims solution is designed to capture data from the forms, export it to the customer’s processing system, and store the image file for future retrieval, if needed.

Claims Processing Flowchart

Benefits of FlexiCapture for Claims by ScanStore

  • Improves data accuracy
  • Reduces data entry time and cost through the use of OCR/ICR/OMR
  • Speeds up the claims capture process

ScanStore’s FlexiCapture for Claims:

ScanStore is ABBYY 2014 Partner of the Year!

Fully Scalable Architecture

From one claim per day to thousands, FlexiCapture for Claims is scalable and can be implemented to support any volume of processing. The FlexiCapture for Claims system can also capture any other business documents you require, everything from satisfaction surveys to Accounts Payable invoice processing, whether hand printed, machine printed, containing checkboxes or barcodes, or any combination of those elements.

Total Flexibility

FlexiCapture for Claims is tailored for processing claims forms using predefined business rules, processing workflows, and field validation rules to ensure data accuracy. With the “standard configuration,” we include one day of services to tailor the system to your specific business needs and project requirements, including validation from your claims processing system, export data formats, and workflow design.

Complete Standard Capture Solution for Medical Claims

  • HCFA and CMS 1500, UB04 and coming shortly UB1450
  • Capture of all fields
  • Single page, multi-page, and attachments
  • ICR (handprint) or OCR (machine print) data captured with the same system
  • Validation of data from your claims system for key data fields
How do I find out more on Claims Processing Automation?

How do I find out more?

Or just watch the video in the next section!

Video Demos for Claims Processing Automation

Claims Processing Automation FAQ Topics:
Claims Processing Automation FAQ How do I keep a running count of the number of pages scanned?
Claims Processing Automation FAQ Can you use OCR to read data from documents if it is not in the same place on every page?
Claims Processing Automation FAQ Can I scan a page with tables or form fields and have the output saved to a Microsoft Excel spreadsheet?
Claims Processing Automation FAQ What is a product that will allow me to create forms and scan completed forms (handwritten) into a database or spreadsheet?
Claims Processing Automation FAQ Assuming a load of 500 documents per day, which Forms Processing software would you recommend in regards to value, reliability, and ease of use with a mid-volume scanner?
Claims Processing Automation FAQ We want to automatically scan different forms, recognize what form it is, and file it for later retrieval. What software do we need?
Claims Processing Automation FAQ Does ScanStore provide outsourced document scanning, OCR or forms processing services?
Claims Processing Automation FAQ Can I scan a completed form into my computer and change the information, written text, or layout of the scanned document?
Claims Processing Automation FAQ I am looking for a software package that will allow me to scan a PDF document and fill in the blanks for electronic invoicing. It appears that your software will allow me to do this. However, I am also looking to have our invoices electronic requiring customers to sign the invoices using an iPad. Will your software package allow a free hand signature as well?
Claims Processing Automation FAQ I would like to scan a document, then fill or type in the blanks. Will OCR software allow me to do this?
Claims Processing Automation FAQ Please let me know if the price stated in the Web site in US$ dollars?
Claims Processing Automation FAQ Is it safe to use my credit card on How do you protect my information?
Claims Processing Automation FAQ What is your return policy? If the product has a problem on delivery how do you handle that?
Claims Processing Automation FAQ Can scanner capture the image of document with shaded part of the document and still recognize information from that section with OCR, ICR or Barcode?

Claims Processing Automation FAQ All FAQ Topics


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