FAQs

What can ClaimsCapture™ do out of the box?

Out of the box, it automates the repetitive and error-prone work that makes manual data entry so painful. It comes equipped to pull in scanned CMS-1500 / HCFA-1500 and CMS-1450 / UB-04 forms, extract and intensively validate their data, and export the results in several common database, flat-file, and EDI-friendly formats. It does all the above in accordance with your unique business rules.

What does it take to get up and running?

ClaimsCapture already includes everything needed for end-to-end claims form automation. Set-up entails little more than installing on your servers/desktop, pointing it at the right folders, and connecting to your organization’s security model.

How long does it take to implement ClaimsCapture?

In most cases, ClaimsCapture only requires two to three days to implement. The timeframe is short because we’ve incorporated years’ worth of client feedback and observations, which translates to hundreds of pre-built features—easily turned on or off—that accommodate business needs right off the shelf.

Can you customize it for our organization?

Absolutely. The same team that built ClaimsCapture can also customize it to incorporate additional form types, integrate with virtually any document source or business application, and follow any business logic that you can describe.

Naturally, customization is always available upon request. Some clients find it highly time- and cost-effective to complete all customization before the initial go-live. Others prefer to begin with a pilot project and add changes gradually. The latter approach works especially well when stakeholders need to see early “wins” with minimal investment.

I like the idea, but how much automation should I really expect after implementing ClaimsCapture?

The quick answer is: it depends on the quality of the document. All of our clients realize a high degree of automation by implementing ClaimsCapture. They often eliminate over 90% of the data entry, document handling, paper storage, and other inefficiencies.

We receive a lot of copies or black-and-white scans of claims, and other OCR tools have a hard time reading them. Does ClaimsCapture support B&W photo- or fax copies?

Yes, ClaimsCapture processes black-and-white claims extremely well—almost as well as the original (red) forms, in fact. On some forms, the challenge is that the data touches the field label, which makes it extremely hard for most software to differentiate the form itself from the data to extract. ClaimsCapture has multiple sophisticated algorithms that are highly effective at distinguishing the red originals from B&W copies, and accurately processing the latter (even from faxes and low-resolution scans!).

Can it export an EDI 837 file to our adjudication software?

Yes, it can export an EDI 837 file with all of the data points that were captured from the claim form. ClaimsCapture’s advanced EDI integration allows clients to quickly ingest the data.

Which document management systems does ClaimsCapture integrate with?

It works with almost every document management system, including SharePoint, OnBase, and many other major and niche solutions. We’ve built it with a flexible approach that exports data and images in many different formats that a DMS can understand.

Can it automatically name the exported files, and the folders to which the claims are exported?

Yes, ClaimsCapture has advanced taxonomy capabilities that can use any claim form data to create folders, sub-folders, and file names automatically.

How much does ClaimsCapture cost?

The pricing model is primarily usage-based, so it depends on the number of claims that you process each year. If the data entry process is fully manual today, then you can anticipate a cost reduction of 80%-90%. That typically brings a return on investment in less than 6 months, and in almost every case, the ROI timeframe is 12 months or less.

How do we get started?

Give us a call! We’ll chat about your needs to confirm that ClaimsCapture really is a good fit, then walk through the systems and people that will make it a success.