Customer Background

To stem the tide of the massive burden of paperwork, many healthcare payers have chosen to outsource the time-consuming task of claim processing and data capture. Health e Connex, a wholly owned subsidiary of Accelerated Receivables Management Ltd., is a leading service bureau specializing in healthcare claims processing. Health e Connex provides outsourcing services for independent physician organizations, third-party administrators, management service organizations (e.g., HMOs) and insurance companies.

Most of the documents Health e Connex processes for its clients are the standard healthcare claim forms, HCFAs and UB 92s. But many other document types are also processed, such as Explanation of Benefits [EOBs] statements, enrollment forms, etc. The key to Health e Connex’s success is consistently delivering top-quality work to their customers’ exact specifications. One of the reasons they are able to accomplish this is because early on Health e Connex recognized the power of automation.

Success from the Start

From the beginning, as the number of clients grew, so did the number of claims Health e Connex had to process. When they reached 10,000 claims a day back in 1994, they decided it was time to automate their manual process and installed award-winning document and data capture software, OCR for AnyDoc® from Tampa, Florida-based AnyDoc Software.

Customers send in their claims either as electronic images or as the original paper documents, which Health e Connex then scans to convert them into electronic images. Then OCR for AnyDoc automatically captures all the essential data from the claim image without manual data entry. One of the main reasons Health e Connex chose OCR for AnyDoc software was its ease of use. “Creating templates to capture the data was very user-friendly; a simple point-and-click interface. The voting engine helped us achieve greater accuracy and OCR for AnyDoc allowed us to customize the data output exactly to our customers’ specifications,” says Brendan Friar, Vice President of Health e Connex.

To ensure quality, human verifiers check the captured information to ensure the customer receives data accuracy levels of more than 99.5%. After processing, the captured data and images are returned electronically to the customer. The images can also be stored online and are accessible via a web browser or on a local area network, totally eliminating the customers’ paper processing and storage needs.

By eliminating manual data entry, Health e Connex quickly quadrupled its output and is now able to guarantee its customer a one-day turnaround time on processed claims. Customers quickly saw an immediate savings in time and labor; and automation allowed Health e Connex to grow and today they process more than 75,000 claim forms every day.

So What’s the Problem?

Health e Connex is based in Illinois, but it provides services for customers nationwide. And as the company became even more successful and grew larger, it was quickly pushing the limits in terms of office space and personnel.

“We had between 100 and 120 workers in our office to do the verification work on the claims processing,” says Friar. “We were running two shifts and space was quickly becoming a problem.” Health e Connex literally had to knock down walls to make room for all the staff.

They needed a solution. And it turns out they already had it with OCR for AnyDoc – Remote Verification. Remote Verification allows users at an offsite location to connect with the main system to perform data verification. Remote Verification works between floors of a building, across the street and, as Health e Connex found out, across the country.

“We were able to eliminate our nightshift and decrease our office staff while retaining our high productivity and accuracy levels. Now 80% of our verification is done remotely from home workers all over America from here in Illinois to even as far as Utah.” Health e Connex was also able to reduce its overhead and operating costs by not having to provide office space and rented furniture for extra onsite workers.

And Remote Verification allows Health e Connex to maintain the same high-level of data security. “We can keep track of what work is out in the field with complete control,” says Friar. Health e Connex can manage the entire workload from a central location since all work must be checked in and out from a central server. Since nothing is removed from the OCR for AnyDoc system, if there are any problems, the original images and data remain untouched and can be redistributed to another worker.

Friar continues, “Our future plans include another AnyDoc Software product, AnyDoc CAPTUREit™.” CAPTUREit is a complete remote scanning solution. Documents can be scanned from any location in the world and sent via the Internet to a central location for processing . “We believe we can save our customers even more time and money by allowing them to save on shipping costs and retain their own paper claims and only sending us the images to process,” concludes Friar.

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