Client Profile.
Leading Data Management Solutions Provider, Texas, USA
Objective.
Verification & updating VAL files of insurance claim forms such as (UB-04 (CMS 1450) – HCFA 1490s – CMS (1500) – ADA Dental) to a web based application; to pace up claims processing.
The Solution.
Upon receiving scanned .tiff images of insurance claim forms along with the Text files called VALs, data entry operators verified and updated VAL files, based on scanned images.
Technology/Software.
MS Excel, FTP Servers, Adobe PDF Reader
Challenges.
- Shortlisting and selecting data entry experts well versed with medical terminologies and technicalities.
- Assessing various data items on the claim forms, meticulously and attentively, so as to ensure that correct information is updated in the text files.
Benefits.
- With assistance and expertise of data entry operators, client successfully lowered claims processing costs without sacrificing the service levels.
- It also helped them gain confidence from patients, and positioned them as one of the leading claims processing firm delivering comprehensive healthcare solutions.
- 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.
Consistent upgrades in our systems, processes and skills, as reciprocation to the ever evolving technological demands, ensure that our offline data entry solutions are the ones with latest technological adoptions to assist our clients to stay competitive.
The Solution.
- Upon receiving files of scanned images (.TIF files) of the Insurance Claim Forms along with the Text files called VALs on a daily basis to attain the count of 120,000 forms month on month.
- Data entry experts were required to verify and update the VAL files while simultaneously viewing the scanned images. For which they used to ascertain various data items on the claim form, meticulously and attentively.
- Once the text file is verified and updated, a thorough Quality Check (QC) is performed on the updated text file to further eliminate the possibility of any remaining errors.
- Quality Checks (QC) were performed on 10% of claims to ensure accuracy. The accuracy of the updated file is compared to the original verification.
- Below mentioned process flow was adhered to:
