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WiseCLAIM

Intelligent Medical Claims Processing Software

WiseCLAIM

Intelligent Medical Claims Processing Software

WiseCLAIM is a Comprehensive Health Claims Processing Software

The WiseCLAIM plugin for ABBYY FlexiCapture is an automated health claims processing software that is designed to provide an automated solution for processing CMS-1500 (formerly HCFA-1500), UB-04 (also known as CMS-1450) and EOB forms. This healthcare claims software is designed to read the text from each of these documents and upload information taken from the forms directly into a claims processing system by an intermediary export of data to variety of files, direct export to ODBC databases, and creation of ANSII Standard X12N 837 output.
Many companies encounter incredibly high expenses for their data entry costs when trying to process these forms manually. The time and resources used on data entry can be greatly reduced by using the WiseCLAIM medical claims processing automation software.
ABBYY FlexiCapture & WiseCLAIM
WiseCLAIM is a complete turnkey data entry automation package for CMS-1500 (aka HCFA-1500), UB-04 (aka CMS-1450) and EOB forms. Based on latest ABBYY form-processing software and utilizing ABBYY FlexiCapture technology, WiseCLAIM provides out-of-box state-of-art processing capabilities with unsurpassed OCR quality and powerful yet flexible exception handling. Popular among healthcare organizations as well as scanning and outsourcing service providers, the WiseCLAIM solution delivers quick ROI and ease of implementation.

Who Needs ABBYY FlexiCapture WiseCLAIM Health Claims Software?

Who Needs ABBYY FlexiCapture WiseCLAIM Health Claims Software?

The health claims processing software from WiseCLAIM is incredibly beneficial to all organizations that enter data from health care claim forms, UBs and EOBs.
The health claims processing software from WiseCLAIM is incredibly beneficial to all organizations that enter data from health care claim forms, UBs and EOBs. There are many companies that have full-time staff that are spending a large percentage of their time dedicated to the task of processing health claims. If you are looking for a solution that will allow your team more time to dedicate to other tasks and save money in the long run then automated forms processing is the simplest solution. When entering all of the data from the CMS-1500, UB-04 and EOB forms manually, you are also at a much higher risk of errors being committed. With automated medical claim processing, you get the most accurate data entry from all of the forms that you submit, both hand printed and typed. This health claims processing solution is the most effective way to get your data entered accurately for every form. This will lead to you saving even more time and money. With the health claims software from WiseCLAIM, you are investing in a way to save time and money in an area that is a significant portion of many organization’s budgets in the healthcare industry. That is why many who choose our health claims processing solution see a significant return on their investment within a short period of time. Let go of the outdated and error-filled data entry methods of the past, and streamline your process with WiseCLAIM.
How This Healthcare Claims Processing Software Works
Not every health claims processing solution is the same and many that are highly streamlined price themselves out of the budget for all but the largest healthcare organizations. WiseCLAIM provides a tangible health claims software solution for any organization that is processing CMS-1500, UB-04 and EOB forms. With the scanning software that we provide, any organization can increase their productivity and form data entry accuracy. With our health claims processing solution, each form can be scanned and its data entered accurately into your database. The reason that this medical claims process automation is helpful is because many organizations have full-time employees that are spending a minimum of 1/3 of their time processing forms. With WiseCLAIM you will have a claims processing software that allows you to free your employees to produce in other areas while reducing the number of errors that occur during the process. WiseCLAIM automation data capture solution provides up to 90% time saving while adding a layer of rules, validation and error checking of your Operators’ entries.
With this health claims software from WiseTREND, you are investing in a way to save time and money in an area that is a significant portion of many organization’s budgets in the healthcare industry. That is why many who choose our health claims processing solution see a significant return on their investment within a short period of time. Let go of the outdated and error-filled data entry methods of the past, and streamline your process with WiseCLAIM.

Advantages of Medical Claim Processing Automation for CMS- 1500, UB-04 and EOB Forms

Advantages of Medical Claim Processing Automation for CMS- 1500, UB-04 and EOB Forms

The CMS-1500, which was formerly known as the HCFA-1500, is a form for official use by all medical equipment suppliers and non-institutional providers in cases when billing Medicare.
The CMS-1500, which was formerly known as the HCFA-1500, is a form for official use by all medical equipment suppliers and non-institutional providers in cases when billing Medicare. There are also other situations that may require this form for government and private insurance billing. This form is one of the most common and essential forms that organizations need to process. Trying to process high volumes of CMS-1500 forms while maintaining the intense level of accuracy that is required is a difficult task for most processors. Usually, manual processors are forced to choose between speed and accuracy. All of the patients, providers, suppliers and healthcare form processors have an investment in making sure that the data is accurately captured without too much time passing. It could even affect personal health outcomes if certain data is inaccurately entered from a CMS-1500 form.
That is why WiseCLAIM provides the health claims software that is guaranteed to: • Reduce the number of errors entered into the data. • Increase the speed of data entry from CMS-1500 forms.
Processing for UB-04 & EOB Form
In addition to CMS-1500 automation, it is equally important to make sure that these billing forms’ data is entered correctly and quickly. The same speed and accuracy (that is provided for CMS-1500 forms) is provided by WiseCLAIM software for these forms. Companies no longer have to choose between what is cost effective, what is most accurate, and what is fastest when it comes to form processing. This health claims processing solution is the best in every area and will save your company time and money while making sure your errors are greatly reduced.

What the Automation Claims Processing Workflow Looks Like

Previously, the workflow for your CMS-1500 processing could have looked something like this:
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Manually enter all of the data from the forms into a spreadsheet.

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Review all of the data to check for errors or inconsistencies.

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Submit the data to be reviewed by another employee to ensure accuracy.

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Then export all of the data into your claims processing database or into an XML data file for later importation.

With WiseCLAIM, your workflow with claims processing automation will look more like:
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Prep papers for scanning by removing staples, unfolding and making them completely flat.

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Place them in the Claims form processors highly efficient scanner.

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The CMS-1500 software extracts the data and determines which data most likely needs to be reviewed.

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Data in question is easily spotted, reviewed and corrected when necessary via a convenient Verification interface.

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Data is exported into the processing database or XML data file to be imported later.

What's the Biggest Difference in the Workflow?

The biggest difference in the workflow, and what makes this health claims processing solution so much faster than manual entry is the incredible amount of time saved on data entry. Beyond the data entry speed increases, the increased efficiency of identifying which data points are most likely to need correction, will also save you time and money. Improve your claims processing workflow with the efficiency of the WiseCLAIM health claims software and increase your data entry accuracy at the same time.
Additional Information About WiseCLAIM Medical Claims Process Automation Software
In addition to CMS-1500 automation, it is equally important to make sure that these billing forms’ data is entered correctly and quickly. The same speed and accuracy (that is provided for CMS-1500 forms) is provided by WiseCLAIM software for these forms. Companies no longer have to choose between what is cost effective, what is most accurate, and what is fastest when it comes to form processing. This health claims processing solution is the best in every area and will save your company time and money while making sure your errors are greatly reduced.
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Admission forms

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Anesthesia report forms

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Blood donor cards

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Chart reviews

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Claim forms (HCFA/CMS/UB)

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Clinical research

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Consent forms

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Dietary forms

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Disease management

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Drug usage

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Encounter forms

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Event report forms

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Nurse staffing / scheduling

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Outcome measurement

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Patient / Physician / Employee surveys

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Patient acuity / history / enrollment

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Timecards

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And More

Additional Information About WiseCLAIM Medical Claims Process Automation Software

There are several forms that the WiseCLAIM health claims software is designed to process. One of the most common forms, that our software processes, is the CMS 1500 form. This was the form that was previously known as the HCFA-1500, which can also be processed by WiseCLAIM software. Finally, our software can effectively process any and all UB and EOB forms faster than any manual entry method. If your organization is looking for a health claim processing software that can increase your levels of productivity, more effectively use your budget, and increase your data entry accuracy, we can help. WiseCLAIM is the health claims processing solution that is designed to help each organization increase their productivity and save their employees time and energy for more important matters than data entry. There is no more effective way to make sure that your healthcare claims forms are being accurately processed and that you are most effectively serving your clients. Find out more about what WiseCLAIM has done to improve the workflow of other organizations in the healthcare medical claims processing business.
WiseCLAIM supports out-of-box processing with further customization options for CMS-1500, UB-04 and EOB documents.  Optional documentation and attachments can be either auto-separated or appended to matching claims.  After processing completes, data gets exported for consequent processing, and claims and matching documentation can be exported to Searchable PDF with full test index for retention and future search and retrieval.
WiseCLAIM supports out-of-box processing with further customization options for CMS-1500, UB-04 and EOB documents.  Optional documentation and attachments can be either auto-separated or appended to matching claims.  After processing completes, data gets exported for consequent processing, and claims and matching documentation can be exported to Searchable PDF with full test index for retention and future search and retrieval.
WiseCLAIM provides pre-set controls for each field in each form and makes it easily configurable for further customization.  For example, WiseCLAIM contains databases for CMS diagnosis codes, CPT codes, and multiple other data points for enhanced data validation and lookup.  WiseCLAIM can also auto-correct common typos and perform intelligent data lookup and substitution actions.
ABBYY FlexiCapture’s WiseCLAIM plugin provides intuitive User Interface (UI) for image-data review.  In this example, WiseCLAIM performs sum check of line items against total amount and highlights a discrepancy on the form.
ABBYY FlexiCapture’s WiseCLAIM plugin provides intuitive User Interface (UI) for image-data review.  In this example, WiseCLAIM performs sum check of line items against total amount and highlights a discrepancy on the form.

Automate Data Processing Within Your Healthcare Organization

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