"We receive approximately 20,000 documents each day, 12,000 of which are claims forms," says Ed Davis, director of support operations for BCBSAZ.
"OCR was a cumbersome two-step process under our old system," says Davis
."We had to perform character verification from within the OCR system, then we would export that data to a separate business validation system we developed to ensure that our business rules were applied.This process increased the time it took to do OCR."
The 2/3 of claims that weren't read by OCR were simply imaged to microfilm for storage purposes and routed in paper form to the appropriate department for manual processing and rule validation.The microfilm media itself posed additional problems for BCBSAZ
."Customer service representatives regularly need to access claims forms to respond to customer inquiries," says Davis
"Customer service representatives no longer have to wait two to three days to retrieve a claim form," says Davis
."They can now access claim images immediately via their desktops."
IMAGING ELIMINATES PAPER, CUTS PROCESSING COSTS IN HALFBCBSAZ
implemented its new claims processing and document capture solution in the spring of 2000, and the results over the past five years have been substantial.First, the solution met the objective of eliminating paper."All paper now ends in our records management department," says Davis
"Prior to implementation of this system, employees who were to do claims data entry had to go through a six-week training course," says Davis
."Now we can get someone up and running in a matter of hours."
The improved OCR capabilities have had the most significant impact on reducing operating expenses for BCBSAZ
."Prior to the imaging project, an operator would process about 35 claims an hour," says Davis
"I see this as a project that could go on forever, expanding to include the entire company," says Davis
..."Most of the other medical claims OCR [optical character recognition] packages had strict canned rules built into the software that could be applied to a claim, but didn't provide the flexibility to change these rules or apply your own," says Ed Davis, director of support operations for BCBSAZ.