R2K

  • Home
  • Services
    • IT Consulting
    • Managed IT Services
    • Systems Integration
  • Solutions
    • Enterprise Content Management
    • Document Capture
    • Capture for Medical Claims
  • Products
    • Hardware
    • Software
    • IBM Showcase
    • Kodak Alaris Showcase
  • Resources
    • News
    • Case Studies
    • Videos and Webinars
      • ECM General
        • IBM Enterprise Content Management: Providing a differentiated value
        • How Mobile is your ECM? 3 key ingredients to make it so
        • IBM Content Navigator Overview
        • IBM Content Navigator
        • Mobile Content with IBM Content Navigator
        • Live product demo: ECM System Monitor
      • Document Imaging and Capture
        • IBM Capture
        • IBM DataCap: Mobile Document Capture Made Simple
        • 5 Rules to Do Mobile Capture Right
        • Reinvent Your Branch Offices
        • Datacap for Accounts Payable Demo
        • What’s New in Medical Claims Processing?
      • Advanced Case Management
        • IBM Case Manager
        • IBM Product Demo: Using IBM Case Manager 5.2 in a project procurement scenario
        • Case Management for Insurance
        • Case Management for Healthcare
        • Case Management for Government
        • Case Management for Banking
        • Case Management for Claims Adjustment
      • Social Content Management
      • Content Analytics
        • IBM Content Analytics
        • IBM Content Analytics with Cognos
        • IBM Content Analytics with Enterprise Search
      • Information Lifecycle Governance
        • Active Information Management with IBM StoredIQ
        • Live IBM Product Demo: IBM Legacy Data Clean-up
      • ECM in the Cloud
        • Trusted Content Management in the Cloud
        • Empower Mobile Workers with Trusted Content Management in the Cloud
        • Introducing IBM Navigator on Cloud
        • IBM Navigator on Cloud (Enterprise Content Management Features)
    • Library
      • Enterprise Content Management
        • Document Imaging & Capture
        • Advanced Case Management
        • Social Content Management
        • Content Analytics
        • Information Lifecycle Governance
      • Business Process Management
      • Managed Services
    • Blog
  • About R2K
    • Management
    • Partners
    • Contact Us
You are here: Home / Solutions / Capture for Medical Claims

Capture for Medical Claims

CapturePoint for Claims

An Award Winning Solution

CapturePoint for Claims is an advanced document and data capture solution that optimizes processing of CMS 1500, UB-04, and ADA 2006 health insurance paper claim forms. Since 1999, R2K has delivered award winning claims capture solutions to health insurance and property and casualty companies nationwide.

Increase Speed and Accuracy while Reducing Costs

R2K’s value-added systems integration leverages technologies from leading software vendors to help customers increase business productivity while reducing costs. Documents are scanned,classified, and exported to the customer’s content management repository.

Claim data is automatically extracted, verified, and delivered to the claims management system. Automatic validation of data is performed through lookups against external data stores, cross-field comparisons, mathematical calculations, and customer-specific rules to maximize accuracy while simultaneously minimizing the need for manual processing.

Benefits of CapturePoint for Claims

  • Improves claim data accuracy and maximizes auto-adjudication rates
  • Reduces data entry cost through the use of OCR and validation rules
  • Speeds the front-end claims capture process
  • Flexible architecture easily adapts to dynamic business requirements
  • Enables easy work distribution
  • Supports rule and process flow
  • Variations for multiple LOBs
  • Improves regulatory compliance and document security
  • Proven ROI

Grow Your Business with R2K’s High-Performance, Scalable Architecture

From one thousand claims per day to tens of thousands, CapturePoint for Claims is completely scalable and can be implemented to suit any volume requirement, no matter how large or small. Other corporate documents can also be captured providing a single point of entry solution for all of your incoming information.

Case Snapshot

A Fortune 500 Health Insurance Company

The Challenge: Improve employee productivity, decrease processing time and increase auto-adjudication rates for front-end processing of more than 22 million CMS 1500 and UB-04 paper claims each year.
The Solution: R2K’s front-end capture and OCR solution using CapturePoint for Claims.
Business Benefits: ROI in 11 months, 15% reduction in suspense rate, 160% increase in productivity, 40% reduction in cycle time, and 65% automated provider coding with 100% accuracy.

Complete Flexibility

CapturePoint for Claims is a vertical solution allowing you to customize “out of the box” claims processing functionality, including pre-defined electronic forms, process flows, validation rules, and lookup tables. Rules are easily modified through a point and click interface or further customized using standard development tools. CapturePoint for Claims provides ultimate flexibility when determining the level of rules processing and real-time edits performed prior to submission to the back-end claims system. Choose to maximize the auto-adjudication rate through comprehensive rules and edits, defer error resolution to the suspense process, or elect for something in the middle – it’s your choice.

 

CapturePoint for Claims Workflow and Key Features

Complete Vertical Solution for Health Insurance Claims

  • Electronic versions of CMS 1500, UB-04, and ADA 2006 forms
  • Pre-configured capture of all fields
  • Single, multi-page, attached and non-standard claim support
  • Dual OCR voting to maximize accuracy
  • Extensive rules and edits
  • Lookups for member, provider, diagnosis code, procedure code, modifier, POS, etc.
  • Support for various export formats including ANSI 837
  • Productivity reports and job monitor

Industry Compatibility

  • Microsoft Windows (multiple platforms and versions)
  • Direct integration with many enterprise content management products
  • Support for leading scanners
  • Oracle and SQL Server database support
  • Multiprocessor capable
  • Server-side runs as Windows services

Business Rule Configurability

  • Extensive library of standard claims processing rules
  • Point-and-click interface for rules management
  • Extensible rules via standard development tools
  • Access to external data stores

Single-Pass User Verification

  • Review of fields flagged by business rules and low-confidence OCR characters
  • Real-time edits and table lookups
  • Auto-advance to bypass validated fields
  • Single key validation override
  • Hotkeys for common operations
  • Full-page and field snippet image display options
  • Automatic field highlighting
  • Rescan and supervisor escalation capabilities
  • Key from image capability available if required
   

Click here to watch the “What’s New in Medical Claims Capture” webinar.

      

FREE IT ASSESSMENT

Fill in the Form Below to Claim Your FREE IT Assessment at No Cost or Obligation!

Offer available for small businesses in NYC with 5 PCS or more.

Follow us on

  • Facebook
  • Twitter
  • Linkedin
Return to top of page
© 2014 R2K, Inc. All Rights Reserved | Terms of Use | Privacy Policy | Sitemap | Careers | Contact Us
 

Copyright © 2019 · Executive Pro Theme on Genesis Framework · WordPress · Log in