Healthcare Claim Processing with ClaimsASP®
As an outsourcer of paper and electronic medical health claims for third party administrators and payers, Electronic Network Systems (ENS) IT staff was challenged to lower costs, reduce the processing time of claims and significantly boot the accuracy of paper claims conversion. ENS has already purchased and fully implemented OCR and image based data entry with an industry leader, but was not seeing the desired results.
Adaptive, through our ClaimsASP solution, is now providing mailroom, scanning and data capture services processing over 100,000 paper HCFA/CMS 1500 medical, UB92 hospital and dental claims daily. Claims are scanned with Adaptive's QScan capture software and the images are transmitted through a secure T1 line to our data center in Dallas, Texas for processing. With our Adaptive Imaging Technology, 99% of all red-dropout claims are processed with multiple OCR engines to obtain top accuracy and eliminate substitution errors. When allowed, images and data are transmitted offshore through a secure connection to China, Bangladesh, India and/or Sri Lanka for low cost character repair and quality assurance. Claims are re-transmitted to domestic locations for Member and Provider matching against customer databases and our unique quality perfection process. All of the volume is processed in 12-36 hours depending on the priority.
ClaimsASP currently processes claims at guaranteed 98.5% claim level accuracy while significantly reducing costs and improving bottom line profitability. With Adaptive's web based reporting, ENS is able to outsource to Adaptive without losing control of the process. Utilization of Adaptive's technologies and services by ENS, has established a winning partnership. Adaptive is now offering our QWebOnline repository with front end search and retrieval capabilities for electronic and image based documents. QWebOnline is allowing ENS and other customers to store EDI documents in the same repository and display the electronic documents as if they were an image of a paper document.
