:: HEALTH CLAIM FORMS DATA ENTRY  
   
 

We process HCFA 1500, BU92, and ADA forms. Our process applications can output resultant data into any of the required format including HIPPA 837 x 12, 835_4010 or NSF format.

We employ a combination of OCR, double key combination. Image sorter analyzes each and every incoming image to decide on OCR / manual entry for first level of data population.

During first level data population each piece of data goes through a threaded data validation process and gets tagged based on suspect levels. Experts at second level data population are then able to take decisions on resultant output data. Continuous comparison and validation of each field as and when they are populated renders resultant data accurate at an unimaginable speed.

Image sorter in the beginning takes perfect control of incoming images. Image sorter recognizes each image as a form, attachment or any other document based on pre-defined document structure thus ensuring every form is entered and documents which do not have forms are returned are dealt with.

We treat each field as a field with its locator data. Members in data entry team never get to see a claim form in full. We have designed a splitter for our clients to split images and transfer through FTP. By this way patient's identity is separated from claim details. The splitter works on an encrypted file naming logic specified by the user thus ensuring re-arrangement impossible by anyone other than the one who split images.

 
     
 
 
     
  Transactions
ASC X12N
 
 
    (i) The ASC X12N 837-Health Care Claim: Dental
  (ii) The ASC X12N 837-Health Care Claim: Professional
  (iii) The ASC X12N 837-Health Care Claim: Institutional
  (iv) The ASC X12N 270/271-Health Care Eligibility Benefit Inquiry and Response,
  (v) The ASC X12N 278-Health Care Services Review/Request for Review and Response
  (vi) The ASC X12N 276/277 Health Care Claim Status Request and Response
  (vii) The ASC X12N 834-Benefit Enrollment and Maintenance
  (viii) The ASC X12N 835-Health Care Claim Payment/Advice
  (ix) The ASC X12N 820-Payroll Deducted and Other Group Premium Payment for Insurance Products
 
   
  NCPDP  
  X12 Standards are required for all HIPAA transactions except for pharmacy claims. In that case, standards developed by the National Council for Prescription Drug Programs (NCPDP) have been adopted.  
   
  Code Sets  
  Diagnoses : International Classification of Diseases, ninth edition, Clinical Modification (ICD-9-CM), Volume 1

Institutional Services : ICD-9-CM, Volume 3 (inpatient only) and HCFA Common Procedural Coding System (HCPCS)

Physician Services :Current Procedural Terminology (CPT)

Dental Services :Current Dental Terminology (CDT)

Drugs : National Drug Code (NDC)

 
   
   
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