Client Profile.
Medical billing & follow up service provider, USA
Industry: Health Care
Objective.
Setting up a process to interpret and enter data from claim form (UB-04 (CMS 1450) – HCFA 1490s – CMS (1500) – ADA Dental) in PDF format to a web based application.
The Challenges.
- Client was operating form a number of autonomous regions, with more than 10,000 healthcare professionals working across more than 12 hospitals and 200 plus primary care centers.
- Every individual; handling multitude of functions; but everything on paper.
- In house process was going to prove very costly, slow and inefficient, with ultimate result in form of inefficient processes and less-than-optimal claims processing.
- Knowledge transfer to in house team, to be at par with existing medical billing industry standards.
- Ensuring smooth transition with bare minimum interruptions.
- Bringing down the error rate considerably while maintaining optimum productivity levels.
- Managing all above well within industry specific turnaround time.
The Solution.
Ongoing process of handling 10,000 plus claim forms every month, using double keying methodology, ensuring high quality output.
Benefits.
- With utilization of evolved technology and expertise of online data entry operators, client successfully lowered claims processing costs without sacrificing the service levels.
- Claim settlement in stipulated time lines is where the client gained maximum, as our accurate and prompt services ensured they do not default, which strengthened their financial reputation.
Value Addition.
Keeping up with ever evolving technological demands, of our clients and for our clients, we consistently upgrade our systems, processes and skills of our employees; to ensure that our Online Data Entry solutions are the ones with latest technological adoptions to assist our clients to stay competitive.
Technology / Software
After comprehending client requirements, it was concluded that a web based application, would be used for interpreting & entering data from PDF forms.
Hi-Tech’s Solution.
- Client was given an option to select 50 data entry operators from a pool of professionals, expert at healthcare data entry tasks.
- Upon selecting the most skilled experts, a workflow was discussed, designed and developed for uninterrupted keying in of data of 10,000 claim forms per month.
- Experienced data entry operators were assigned to process UB-04 (CMS 1450); HCFA Form 1490s (Patient’s Request for Medical Payment); CMS 1500 (Health Insurance Claim Form); ADA Dental Claim Form etc., with help of double keying methodology to ensure highly quality output.
- All the entries were audited by Quality Assurance team before processing the files & then provided to clients with real time status reports about number of files in process and the ones processed.
