DATA CAPTURE

HEALTH INSURANCE CLAIMS

  EOBs
  CORRESPONDENCE DOCUMENTS
  SURVEY FORMS
  DRUG FEEDBACK FORMS
  MORTGAGE & TITLE DOCUMENTS
  AIRLINE INVOICES
  REFUND REQUESTS FOR AIRLINE TICKETS
  WIC COUPONS
  RETURNED MAILS

   

Data capture from Health Insurance Claims

HFCA-1500/CMS, UB-92/UB-04, Nonstandard Forms, Dental Forms

We process around 100,000 claims a day on peak days. Our state of art infrastructure can scale up this capacity to double at a short notice. The forms printed in non dropout black ink, or hand written claims are scanned and routed to key-from Image Process (KFI) where double blind data entry is performed. The forms printed in red dropout ink, or type written are scanned with red bulb to remove the background & routed to OCR engine. The field content filled up by OCR engine is validated and claim is processed using Reject Repair Process (RR). The documents which cannot be OCR'd with more than 80% accuracy are sent to Key-From Image Process.

The scanned images are sent to the Processing Center in batches where trained operators process these images using set of Business rules which are devised after detailed understanding of the client's requirements.

After the KFI & RR stages, the claims pass through verification stage. All output is checked through well defined validation tables & exceptional fields are flagged. Such flagged claims are then passed through a flag removing operator.

Experienced auditors perform the final audit of claims processed by operators before submission to client. The output data is submitted to clients in the format specified by the client.