Customer Background: The Loomis Company has a goal to be recognized by its clients as the best insurance services company in the United States. And because it generates more than 80% of its business as a third-party administrator for medical claims processing, Loomis focuses much of its resources into providing its customers the highest level of speed and accuracy.

In no other field is the need for correct information as great as in the healthcare market. Therefore, Loomis knows how imperative it is to ensure maximum data accuracy for all its clients.

The Need for Speed

Achieving the highest level of data accuracy often comes with a price. It takes time to get everything right. Originally, Loomis relied on a manual data entry staff to key the data from the incoming medical claim forms (i.e., HCFAs and UB92s).

Medical claims were sent to Loomis for processing, posting and storage. Claims arrived daily in its mailroom. They were then opened and manually pre-sorted into one of over 400 different insurance groups. All the claims in their respective groups were then given to Loomis’ data entry staff of 12 to manually enter the claim data into the computer system in the order they arrived. Only until all the relevant data was entered into the system, could claims be reviewed and paid. On average once it arrived at Loomis, it took three to five weeks for a claim to be paid.

Once the data was keyed, the paper claims were boxed and kept in a storage room. When the room got too full, the boxes of claims were moved offsite for storage. If a specific claim was needed later, an employee had to track down the correct box, locate it on the shelves and pull the box to get a copy of the claim document. If the box had already been sent offsite for storage, a special form had to be filled out and Loomis had to wait three weeks for the specific box to be located and delivered. Then a Loomis employee still had to search through the box, hoping the needed claim wasn’t misfiled or lost.

With thousands of claims arriving daily, Loomis started to look for a solution to not only increase the turnaround time, but also to maintain its high data accuracy and improve customer service levels. Also, Loomis wanted the solution to have the ability to do electronic document imaging. A tall order, but not as difficult to achieve as Loomis might have feared.

Automation is the Solution

A consultant Loomis was working with suggested the automated document and data capture solution OCR for AnyDoc® from Tampa, Florida-based AnyDoc Software. OCR for AnyDoc prided itself that it could virtually eliminate the need for manual data entry while ensuring the highest level of data accuracy possible.

Loomis’ system for processing the claims is quite different now. Today, all the claims that arrive in the mailroom are opened and immediately scanned without the need for any pre-sorting. OCR for AnyDoc reads the scanned claim and automatically captures all the vital information off the document and electronically stores the data along with the scanned image of the claim. Only if OCR for AnyDoc encounters any questionable characters when extracting the data off the claim, is it then sent to an operator for verification or correction. 25% of claims are completely automated and require no human intervention whatsoever.

Loomis now routinely processes claims in 48 hours with 87% of claims being paid within four days. That’s a whopping 190% increase over the manual method. By switching to an automated system, Loomis saw a 60% leap in productivity. And if a copy of a processed claim is needed, an employee can instantly retrieve a full color electronic image of the claim right at their desktop PC.

Benefits Beyond the Bottom Line

In addition to productivity and accuracy levels soaring, “Customer satisfaction levels are through the roof,” says Pete Gettel, Senior Business Analyst for Loomis. “Before we were reactive. As a result of OCR for AnyDoc now we can be proactive.” Management at Loomis is now able to get online reporting of throughputs, production levels and accuracy. Gettel continues, “We’re no longer in emergency mode anymore so we can take the time to see what other services we can provide our customers to ensure the claims are handled fully.”

Loomis is processing between 4,000 and 5,000 claims per day with less staff than before. Gettel says, “We only need four verifiers to do the work that used to take 12.”

Gettel concludes, “We have been extremely pleased with OCR for AnyDoc. On the few occasions where our servers have gone down, once we reboot, OCR for AnyDoc picks up exactly where it left off without a hitch. I’m proud to say we’ve never lost a document with OCR for AnyDoc.”

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