CapturePoint for Claims Processing

Take advantage of CapturePoint to significantly improve claims processing efficiency and cut costs. R2K offers CapturePoint/claims, a proven document capture solution for processing CMS 1500 and UB-04 forms to support:

A claims-specific framework for managing the entire capture process flow and to export documents and data
Form recognition, OCR, data entry and data validation to reduce cost of manual processing and increase accuracy
Enterprise management tools for end-to-end reconciliation and complete process monitoring to ensure data integrity and improved productivity

CapturePoint/claims Features and Workflow

Automatic form identification
Advanced image enhancement
Highly accurate OCR recognition
Both out-of-context character repair and in-context key-from-image capabilities
Dynamic routing
Intelligent workload balancing
Standard exports to a variety of back-end systems
A rich set of management reporting data
Proactive systems management and controls
Highly flexible and open framework capable of easily accommodating changes in business requirements

Claims Processing with CapturePoint
Click for an enlarged view

Key Technical Information

High-performance, scalable, client/server architecture:

Workload balancing to allow each client to process at its optimum speed
Closely integrated with Windows platform tools for manageability
Image rotation allows landscape scanning for higher throughput
Flexibility to logically distribute and process work at various levels including batch, folder, document and page
Automatic recovery and reassignment of failed transactions in the event of unexpected client termination

Scanning and Recognition:

Supports over 160 scanner models at production speeds
Recognizes single-page and multi-page CMS 1500 and UB-04 forms
Image enhancement during preprocessing for optimal recognition
Intelligent recognition validates OCR results using a rules engine to improve OCR confidence levels

Data Correction and Key-from-Image Correction:

Two interfaces for performing manual repairs
- Dedicated character repair (out-of-context)
- In-context data correction
Character repair designed for high-speed, heads-down processing
Non-OCR forms are identified, routed past recognition and sent directly to key-from-image for manual entry to increase efficiency
Flexible dynamic routing to get the right work to the right workstation at the right time
- Workstations can be dedicated to a single type of processing
- Documents can be processed by the knowledge worker with business experience and access to backend systems
- Work distributed along line-of-business

Edits and Rules:

Comprehensive dual-pass rules evaluation
- Rules evaluated after recognition and again after the first-pass repair
For low-confidence fields, performs table lookups to validate data, increasing confidence levels and improving accuracy
Field edits invoked during data correction to minimize errors

Data Management:

Custom reporting and reconciliation database tracks and maintains historical data on all batches and documents, providing a wealth of statistical data for generating custom reports