Transform Claims Processing with ClaimAction
Make your medical claims processing more efficient with ClaimAction. This cutting-edge software can automatically process CMS 1500 (HCFA), CMS-1450 (UB04), and ADA Dental claim forms, extracting and validating data from EVERY field and table. ClaimAction is equipped to handle black and white and drop-out scans, making the process seamless. Book a demo now
The automation of medical claims is a crucial component in contemporary healthcare operations. Solutions like ClaimAction streamline the management and processing of millions of medical claim forms, including CMS 1500 HCFA, UB 04, and ADA dental form, benefiting BPOs and healthcare organizations. ClaimAction solution is pre-configured to capture every data field from medical claim forms that helps healthcare providers to streamline their workflow, reduce errors and improve healthcare claims process management.
Captured data is processed for authenticity and verified. Post verification, claims may be approved or rejected. All the data is exported to your back-end systems, where extracted data transactions are recorded automatically in a HIPAA-compliant 837 data format, as well as industry-standard XML, JSON and other formats.
Business Process Outsourcing (BPO) companies and healthcare providers utilize ClaimAction, a machine learning/AI software solution for managing medical claims processing.
Artsyl’s ClaimAction is an intelligent process automation solution that taps into its embedded machine learning, advanced data capture technology, and AI-enabled workflow automation capabilities to streamline processing of medical claims.
A no-code architectural framework means ClaimAction can be quickly configured to meet individual business requirements, without the need for custom coding or extensive professional services. ClaimAction supports intelligent document processing of diverse types of healthcare claim forms.
ClaimAction is the best business process outsourcing software for
CMS 1500/HCFA, UB-04, and ADA dental forms automation.
The benefits of using ClaimAction for medical claims processing include:
Improved Efficiency: ClaimAction's advanced automation and document processing capabilities reduce the need for manual data entry and processing, resulting in faster claim processing and increased productivity.
Accuracy: ClaimAction's embedded machine learning technology enables the system to recognize patterns and make accurate predictions, reducing errors in claim processing.
Cost Savings: By streamlining the medical claims processing workflow, ClaimAction can reduce the need for additional resources, resulting in cost savings for healthcare providers and BPO companies.
Customizability: ClaimAction's no-code architecture allows for easy customization to meet the unique needs of individual businesses, without requiring custom coding or extensive professional services.
Scalability: ClaimAction is designed to handle high volumes of claims, making it a scalable solution for businesses of all sizes.
Fast Implementation: ClaimAction's quick configuration process enables businesses to implement the solution quickly, with many clients seeing results in as little as 60 days.
Automate medical claim forms effortlessly with Artsyl ClaimAction.
Extract and auto-validate data from ALL fields and tables,
including black and white and drop-out scans. Book a demo now
Medical claims automation is crucial for United Healthcare providers. By automating the claims process, providers can reduce costs, improve efficiency, reduce errors and enhance the customer experience. This helps them to navigate the increasing complexity of the healthcare system, comply with regulatory requirements and focus on delivering quality care.
ClaimAction offers a range of features that facilitate medical claims processing, including:
Flexible Input Sources: ClaimAction can handle a variety of input sources, including scanning operations, fax servers, remote web storage facilities, and all common image file formats, including PDFs.
Automatic Job Registration ClaimAction can monitor multiple local folders, web folders, and email addresses, automatically registering jobs as they appear from any of these sources.
Multiple Claim Types: ClaimAction automatically processes CMS 1500 forms, also known as HCFA forms, and UB04 and their old format equivalents UB-92, both single- and multi-page. ClaimAction can also process a variety of medical claim types, including ADA dental claim forms, regular claims, Advantage claims, Crossovers, and other claim types and supporting documents.
Full Audit Trail: ClaimAction provides a complete audit trail of all administration/security actions and changes enforced in the claims processing system.
Advanced Reporting Suite: ClaimAction's reporting suite is tailored specifically for medical claims processing, allowing businesses to track workload, identify bottlenecks, analyze employee performance, and compare current efficiency with historical data in real-time.
Let Artsyl ClaimAction simplify your workflow by automating your medical claims process.
How to process medical insurance claims electronically?
Healthcare providers, business process outsourcing (BPO) and any other companies can automatically process medical claim forms using the ClaimAction software that process medical claim forms automatically, no matter if they come in electronically or arrive in paper format. The software is designed to capture data from all fields and tables of medical insurance claims forms, including CMS 1500/HCFA, CMS 1450/UB04, UB 92 and ADA Dental forms. Ordering a demo of the software is a simple way to see how it can streamline the process of capturing and processing data from these forms.
Who processes medical and dental claim forms, and which organizations benefit from ClaimAction?
Healthcare organization
Medical claims processing is required by healthcare providers, such as hospitals, clinics and medical practices, as well as insurance companies and government agencies that provide healthcare coverage. These organizations need to process large volumes of medical claims on a regular basis to reimburse healthcare providers for the services they provide and ensure that patients receive the appropriate coverage for their medical expenses. For automation of CMS 1500 (HCFA), UB04 (CMS-1450 form), UB-92 healthcare providers use medical claim processing software such as ClaimAction or outsource the claims processing to BPO companies.
BPO companies
Business Process Outsourcing (BPO) companies process medical claim forms on behalf of healthcare providers and insurance companies to reduce the workload and cost associated with managing the claims process internally. Outsourcing the claims processing function enables healthcare providers to focus on their core competencies, such as providing quality healthcare to patients, while the BPO company takes care of the administrative tasks involved in managing the claims process. BPO companies use medical claims processing software as ClaimAction to processes large volumes of medical claims forms, ensuring that they are processed accurately and in a timely manner. This helps healthcare providers and insurance companies to reduce errors, minimize delays in claims processing, and enhance the overall efficiency of their operations.
Dental insurance companies
Dental insurance companies play a crucial role in the healthcare ecosystem by processing ADA Dental Claim Forms submitted by dental practitioners. As a pivotal intermediary, these insurers meticulously assess each claim to determine its eligibility, coverage, and reimbursement details. This involves a thorough evaluation of the services provided by dental practitioners to ensure alignment with the terms and conditions outlined in the insurance policies. The processing of ADA Dental Claim Forms by insurance companies is a complex yet vital aspect of the dental billing and reimbursement process, contributing to the overall efficiency and accuracy of financial transactions within the dental healthcare domain.
Dental practitioners
Dental practices are at the forefront of utilizing ADA Dental Claim Forms to facilitate the billing and reimbursement process for the services they provide. When dental practitioners render dental care to patients, they use the ADA Dental Claim Form to document and submit details of the services rendered. This submission initiates the crucial process of claims processing, wherein dental practices seek reimbursement from insurance companies for covered services. The ADA Dental Claim Form serves as a comprehensive record, allowing dental practices to communicate essential information to insurers, ensuring clarity on the types of services provided, their necessity, and the associated costs. This seamless interaction between dental practices and insurance companies enhances transparency and efficiency in the financial aspects of patient care.
What type of medical claim forms can ClaimAction process?
CMS 1500
ClaimAction automatically process medical claim form - CMS 1500. This form used by united healthcare providers to bill for services provided to patients. CMS 1500 form contains information about the patients, the healthcare providers, the services provided and the details about the costs for the provided healthcare services. The CMS 1500 form is used for billing by a wide range of healthcare providers, including physicians, dentists, chiropractors, ambulance services and others. CMS-1500 claim form is recognized by most insurance providers, including Medicare and Medicaid and is a critical document for healthcare providers to receive reimbursement for the services they provide.
HCFA
HCFA stands for the Health Care Financing Administration. HCFA-1500 form is the old name of the CMS 1500 form which can be processed by Artsyl ClaimAction solution automatically. In 2001 the HCFA was renamed to the Centers for Medicare & Medicaid Services (CMS). The CMS is a federal agency within the United States Department of Health and Human Services that administers several health care programs, including Medicare, Medicaid and the Children's Health Insurance Program (CHIP).
Automate your medical claims process with Artsyl ClaimAction.
Our software effortlessly processes CMS 1500/HCFA and CMS-1450/UB04 medical claim forms, extracting and validating
data from every field and table.
Book a demo now
UB04 (CMS-1450 form)
The UB-04 also known as CMS-1450 form is a standard medical claim form used by healthcare providers to bill Medicare and Medicaid and private insurance companies, for inpatient and outpatient services. The form contains: Patient information, Insurance information, Provider information and the list of provided services and the charges for those services. The UB04 form is used primarily by hospitals, nursing homes and other inpatient facilities. ClaimAction is pre-configured to capture data from all 81 fields of UB04 CMS-1450 form and its table part.
UB-92
The standard medical insurance claim form previously used by health care organizations and hospitals to bill insurance and Medicaid payers was the UB92 form. However, in 2007, the National Uniform Billing Committee (NUBC) officially replaced it with a revised version known as the UB04 form. During the revision process, several additions were made to the UB92 form to create the UB04 form. The most notable change was the inclusion of a field for National Provider Identifier (NPI) input. Other new fields such as more diagnosis code fields were also added. ClaimAction can automatically capture the data from the old UB92 forms as well as from the modern UB04 medical claim forms.
ADA Dental Claim Form
The American Dental Association (ADA) Dental Claim Form is a standardized document widely used in the United States for submitting dental claims to insurance providers. This form ensures consistency in the information provided by dental practitioners, facilitating a streamlined billing and reimbursement process. It includes essential fields such as patient information, treatment details, and associated costs.
ClaimAction, an advanced software solution, significantly enhances the efficiency of processing ADA Dental Claim Forms. With its automated capabilities, ClaimAction can seamlessly extract data from all fields within the form. This automation not only expedites the claims processing workflow but also minimizes the risk of manual errors associated with traditional data entry methods.
By leveraging ClaimAction, dental practices, and insurance companies alike can benefit from accelerated processing times, increased accuracy, and improved overall efficiency in managing dental claims. The software's ability to automatically extract data from ADA Dental Claim Forms contributes to more seamless and error-free interaction between dental practitioners and insurance providers, ultimately enhancing the entire billing and reimbursement process in the dental healthcare sector.