Revolutionizing Claim Management: Insights From Three Firms on the Impact of Smart Data Entry Systems

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Three companies share how intelligent capture transformed their claims processing

Bruce Orcutt

August 29, 2017

Despite the prevailing electronic exchange of information between healthcare payers and providers, a big portion of medical claims are still issued on paper and fax. Three forward-thinking companies took action. Using ABBYY FlexiCapture, they digitally transformed their claims processes to improve efficiencies in three common claims scenarios: paper, fax and EDI.

Vision benefits provider eliminates paper

Community Eye Care (CEC) is an organization that struggled with manually processing HCFA 1500 sheets. CEC administers vision benefits for employers’ associations and health plans. Among the 150,000 HCFA 1500 forms it processed every year, 56,000 were paper. Processing the paper forms required four people conducting tedious and error-prone manual input. CEC deployed ABBYY FlexiCapture to automate the process and for its superior OCR recognition and verification capabilities.

“We’ve seen nothing but great results,” commented said Amy Eatmon, COO/Director of IT, Community Eye Care. “We’re able to keep our prices down, simply because we’ve become so much more efficient. The software has increased our productivity as well as employee satisfaction and has eliminated the need to bring on additional staff.”

Corporate wellness provider transforms data from faxed forms

ADURO is a wellness platform provider that includes biometric testing and requires the manual processing of physician fax forms. Biometric testing measures markers such as body mass index, blood pressure, cholesterol levels and glucose levels. The process begins when employees provide their physicians with a form. Each form is tailored to its client and features a combination of bubbles and handwritten notes. When completed by a physician, it is faxed to ADURO for processing.

“It’s vital to get that information into our database so employees can get on with their programs, get their awards and work with their coaches,” says Dr. Mark Thompson, co-founder and Salesforce Administrator at ADURO. “We had to reclaim lost efficiency and maintain excellent service for clients’ employees.”

ABBYY FlexiCapture not only automated the pulling of data from the forms, but also transformed the workflow: incoming faxes are now routed to a HIPAA compliant online fax service that automatically assigns them to the appropriate customer folder on a server. From there, the physician fax forms are loaded on to workstations, then software recognizes and captures the forms’ data. Within the first three months, ADURO was able to successfully process 5,000 physician fax forms. One person is able to process up to four times as many documents than before.

Podiatry plan achieves compliance with EDI claims submission

Podiatry Plan , a provider of podiatry medicine for Labor-Employer Trust Funds (ERISA), provides routine foot care for Medicare beneficiaries. It had an urgent need to digitize CMS-1500 forms fast.

“Essentially,” says Annie Scherer, Office Manager at Podiatry Plan, “We were told that CMS-1500 claim forms would need to be submitted via EDI instead of fax – and that only two months were available to make the transition.”

Implementation was only two weeks. Today, Podiatry Plan processes claims for a very large number of the Medicare Healthcare Plan’s beneficiaries and receives several hundred claims every month using intelligent capture that automates and streamlines the process workflow.Click to learn more .

Healthcare Intelligent Document Processing (IDP)

Bruce Orcutt

Senior Vice President of Product Marketing at ABBYY

Bruce Orcutt is a veteran Product Marketing and Product Management professional with over 20 years’ experience in Enterprise Software. Bruce drives global product marketing for ABBYY’s intelligent automation solutions that create business value for organizations. His go-to-market strategies accelerate the adoption of ABBYY solutions worldwide.

Connect with Bruce on LinkedIn .

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