Patients shouldn’t be burdened with medical costs in these difficult times. Artsyl’s automated claims processing software helps payers offer timely reimbursements for anyone seeking treatment
The COVID-19 pandemic has thrust upon providers a sense of urgency in delivering healthcare services to patients. Not just care givers, healthcare insurers and the larger payer networks are also gearing up to aid in the immediate delivery of care, pursuant to the revised waivers and rules listed in the Interim Final Rule and the regulatory flexibility accorded to providers by the US Department of Health and Human Services.
As for the patients, immediacy in care delivery aside, their other major concern is reimbursements for medical costs. The pandemic has prompted insurers to act in the most effective and prompt manner to medical claims and claims processing. Insurance companies are working hard to handle the mounting number of medical claims and reimburse patients as quickly as possible. Some insurance companies have offered to waive the mandatory pre-authorization checks and referrals in order to expedite claims processing.
Expediting claims processing can be best done with intelligent process automation. Paper-based transactions often delay reimbursement cycle times and are costly. According to a report sponsored by Change Healthcare, paper-based claims processing costs the US healthcare system nearly $300 billion in administrative expenses annually. On the contrary, shifting to automated claims processing could save the healthcare system around $375 million per year just in direct claim data entry costs. Electronic claims processing is especially useful for providers enrolling with multiple payers, considering the number of paper check payments that could be processed automatically.
AHIP, a renowned healthcare association, committed to providing coverage to millions of Americans, has been monitoring the COVID-19 crisis closely, and estimates the costs of combating the pandemic at around $556 billion. Given the massive monetary burden on healthcare providers, associated facilities, and patients, some insurers have offered to waive out-of-pocket costs related to COVID-19. In a way, expediting claims processing also makes sense when you think about the exponential costs of healthcare and the necessity to reimburse in a timely manner to avoid a catastrophic monetary loss to all stakeholders involved.
Artsyl’s ClaimAction offers automated claims processing that speeds-up data entry, minimizes touch points, and eliminates processing bottlenecks so you can route claims documents automatically to the right claims examiner for expedited verification, approval, and reimbursement. Given the worker and workplace constraints in these times, automated claims processing and reimbursement is the best option for insurance companies. Artsyl’s ClaimAction is built on a platform of Digital Transformation technologies such as AI, RPA, and Machine Learning that help automate and integrate the acquisition, classification, data extraction, validation, and sharing of medical claims data, thereby greatly accelerating reimbursements while reducing the overall operating costs.
ClaimAction is designed to automatically extract and capture data from the CMS 1500 (HCFA-1500) and CMS 1450 (UB-04) forms, used by individuals and hospitals, respectively. The medical claims software is highly customizable and can be configured to follow business workflows according to each payer’s 835, which is unique. ClaimAction automatically matches an insurer's 835 to the 837 claim form submitted by a healthcare service provider for reconciliation and final payment. ClaimAction’s open architecture also enables complete automation of claims cycle through integrations with back-end systems and ERPs for automatic generation of claim records in HIPAA-compliant data formats. Artsyl’s claim form software provides predefined workflows for a diverse range of CMS, medical, and dental forms. Payers can benefit from a completely automated claims processing workflow from submission to reimbursement using ClaimAction, and accelerate payments so that cost concerns do not keep people from seeking treatment in these difficult times.