eClaimScan's Imaging Process for Accurate Data and Document Management

Our Imaging Process

To date, eClaimScan has processed exactly $239,657,554,413.57 in claims for our clients. Here's how we successfully manage over a billion dollars of claim data:

Perfect Claim Tracking

We track every claim from the moment we receive it, using a robust MS-SQL Server to manage every bit of claim data from that point forward. Our shipment accounting system captures courier tracking number and claim counts, but will also accept additional tracking information; for example, some of our clients include a total-dollar checksum, the name of the packager, or their own internal dating information. Because we take claim accountability as seriously as you do, we are prepared to track claims as specifically as you require.

Our infrastructure keeps an audit trail of all claim access, by our employees as well as yours, in accordance with HIPAA regulation.

Great Images

Scanned images take up no room at all - but are even more versatile than paper. Electronic documents can easily be retrieved and inspected. When you need it, you can print a hard copy that's at least as good as any photocopy or microfilm of the original.

We scan our documents using Kodak digital scanners, the industry standard in imaging equipment.The Kodak system organizes each group of similar claims into a named unit called a batch. Each batch contains claims from only one client shipment, so that we can continue to track each claim by the date our client sends it.At the time of this writing, our facility is equipped to process up to 180,000 document scans per day.

Reliable Data

Quality Assurance starts as soon as the packages are opened. The success of our Zero Error Strategy depends in part on a careful review and sort of each item out of the package. We process HCFA-1500, UB-92, and ADA claims for EDI, and can also implement procedures for management of nonstandard claims at your request. By organizing claims according to form type, number of pages, and repricing status before processing them, we give our OCR, hand-key, and auditing systems several advantages in error prevention, detection, and correction.

Next, we combine OCR and hand keying to produce a raw data file from each claim. Some of our clients provide us with eligibility lists of employees and providers, enabling us to perform some data verification and error correction immediately and automatically. Multi-page and poor image quality forms are hand keyed by trained claims analysts to ensure accuracy.

These raw data files are then audited for accuracy by a claims specialist aided by intelligent software that detects invalid data, codes, and amounts. The specialist has the ability to instantly call up the image of any questionable forms to rekey bad data. After auditing the files, the specialist creates the EDI file for delivery to you via the secure mechanism of your choice.

Custom Workflow

Every one of our clients does business differently. Our experience with the administration industry allows us to handle your firm's special requests: multiple formats, special procedures, and new technologies integrate naturally with our existing infrastructure. Our Rapid Development programming staff provides you with tailored software that works with turn-key ease.

Security

When the process of imaging, conversion, and claims payment is complete, our clients determine the fate of the paper claims. We generally destroy all paper claims after 90 days, although some clients prefer to have the paper returned to them. We commonly provide an archive of all images on CD-R or DVD, as an optional service.

Recognizing that the implications of the HIPAA regulations are long-term and that modifications to the standards will likely evolve more quickly once in force, we have begun implementing exceptional security practices immediately. Our data server will exceed HIPAA mandates for security, managing access to the user level by requiring individual passwords, and by providing data encryption and user authentication by digital certificate.

The Bottom Line

Get out from under the paper. Partnering with eClaimScan empowers your firm to outsource much of a process that is inherently resource-hungry, not only in information processing but also in risk management. With our support, your firm remains focused on your mission, despite the complexity of the tasks.