OCR Medical Claims Systems Capture

Medical Claims Systems Capture

OCR has specifically developed a medical claims systems form scanning and processing solution for our healthcare partners.

The system is preconfigured to scan, capture, verify and route medical claim form data to your back-end system automatically so that manual data entry of each form is no longer necessary. This will help with your healthcare claims processing workflow!

The OCR medical and healthcare document scanning and imaging software comes pre-configured for electronic OCR medical form processing to read all the fields in the CMS-1500 (also known as HCFA) as well as healthcare claim form UB-04, Dental Claim Forms and more to optimize your claim processing in healthcare. Using our user-friendly interface, there is no need for programming.

Medical Claims Systems Capture Benefits Include:

Significantly speed up the healthcare claim processing time in your operation
Improved process productivity with faster response to your customers
Ability to extract additional data points from claim documentation to enable advanced processing
and analytics for marketing, actuarial and claims departments
Hands-on caring support, in most cases issue is resolved the same day
Quick integration into other EMR, EHR and practice management systems
Scalable system that is built to expand as you grow
Eliminate manual data entry
Fast deployment
Claim related data extraction with improved accuracy/quality
Improved client experience through less data input

Process

As with all our solutions, the process is simplified to make it simple and easy for your operation.

Smart Document Capture

Capture

Capture any type of document from any source.

Classify

Identify and sort documents using supervised machine learning.

Extract

Extract the metadata from documents.

Validate

Receive alerts on any errors or exceptions.

Deliver

Automatically sends data to any application, either on-premises, hybrid or cloud.

The system will ingest all claim documents from a watched folder, email or fax and begin processing the documents. All documents will be OCR’d and their information will be digitized. The system is a complete thin client solution thus having a very small footprint on the client machine. The user will go to a URL and log into the system thus helping conform to HIPAA security regulations by users having no access to the actual documents and speeding up the healthcare claims processing workflow for your company.

There are two main user profiles:

Administrator
Operator

OCR specializes in Medical Claims Systems forms processing.

We have developed a core medical claim form workflow that will save you an incredible amount of time with your healthcare document scanning. Just give us your keying rules and requirements and we will help get you automation and efficiencies in your medical claims and medical documents process.

There are two main user profiles:

Administrator
Operator

OCR specializes in Medical Claim forms processing.

We have developed a core medical claim form workflow that will save you an incredible amount of time. Just give us your keying rules and requirements and we will help get you automation and efficiencies in your medical claims and medical documents process.

Capture

The docMax system can capture the document images from virtually any method. The system is preset to give you choices on how you want to ingest the invoices. Directly from a scanner, Mobile PHone, Portal, Fax Server, Email or the most common a watched folder on the network. Using watched folders is extremely simple, just scan or place the images directly in the folder and let the system will do the work for you.

Image Processing

In this phase the system will prepare the image so that the OCR results are as accurate as possible. The system has pre-programmed algorithms that remove speckles, punch holes, auto rotate, eliminate blank pages, enhance hard to read characters and more. This is a very critical part in the process that greatly enhances your capture results. Once the image is ready the OCR engine will read and digitize the data so it is ready for the next phase in the process.

Classification

Just like organizing your files at home OCR’s docMax system organizes your digital documents. The system will detect the document type and auto classify every document that goes into the system.

Extraction

This is the frontier of accuracy and automation. Data extraction deals with two very important functions:

Voting on low or high confidence characters – alerting and directing the user to fields that may have incorrect words or letters.
Business Rules – This can be something as simple as ensuring a field to always be a date and have a proper format such as MM/DD/YYYY or DD/MM/YY. Business rules can also include a database lookup in order to compare captured information to information in your company database.

Validation

Once the above processes are complete there are two options for the documents to travel.

If there are no low confidence characters and all business rules are met, the system will immediately export the document and its data.
If there are rules or confidence scores that show up the image and its data will be sent to the verification station.

The verification station is a thin client that by design does not require installation or documents on the user’s machine. The user points to a URL and logs into the system.

Export

The docMax system gives you many export options. Exporting data with our medical claims package allows you to export an 837 output format as well as XML, CSV, JSON and more. If you have a unique output format that you need the system allows you to customize the data output. Image output is flexible as well and can be PDF, TIF, JPG and more.

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