How Intelligent Data Capture Can Maximize Reimbursements

The cost of electronic health record non-compliance can take a bite out of reimbursements as Medicare financial penalties for not achieving meaningful use loom.

Consequently, improving office operations by eliminating costly manual processes and handoffs for patient billing is central to maximizing reimbursements. It starts with intelligent capture of the paper that drives or is created by accounts payable functions, invoice processing, insurance identification, admission forms, and documentation of treatments and procedures during all the touch points between doctor and patient.

Intelligent document capture can transform a practice and free significant time for doctors to treat more patients each day. Digitized documents are automatically transformed into actionable information ready for coding and submission for reimbursement. Information is routed to the right people, processes and backend systems — enabling organizations to become more efficient while reducing costs.

By eliminating paper-based information, hospitals, specialists and general practitioners can improve productivity, eliminate lost billing opportunities, and enable better visibility into patient billing, regardless of where it is in the revenue cycle.

You can utilize the devices you already have available such as smartphones, tablets and document scanning systems to initiate intelligent document capture. Using a combination of these devices also enables you to centralize patient information, more quickly perform diagnoses and recommend treatment options, and streamline generation of accurate bills.

For example, a unified document capture platform enables health care organizations to automatically classify, extract data, validate information and trigger workflow and processes from the structured and unstructured patient and clinical information contained in admission documents, charts, test reports, MRIs, x-ray images and other documents.

The technology securely routes information to the EHR and other systems of record so that authorized personnel can access it in real time at the point of care and when generating bills.

You can also audit the processing of all documents from the point of receipt and have the scalability necessary for compliance as well as for future growth of your healthcare organization. Document capture technology also improves data security and reduces fraud by limiting manual handling of medical records and other documents, and by eliminating the physical storage of documents.

Here are five benefits of having document capture automation within your healthcare organization:

* Capture, classify, separate pages and index documents automatically;

* Extract and validate information from documents and update systems of record to utilize that information throughout your processes;

* Streamline billing processes by reducing the time it takes to collect information from hundreds of variations in explanations of benefits (EOB) documents received from payers;

* Access more information at the point of care and free valuable time to meet the health needs of more patients each day; and

* Audit the processing of all documents from point of receipt to archival.

Once the document capture is automated, claims processing automation is the next area where efficiencies will impact the bottom line.

With the impending ICD-10 compliance deadline nearing, healthcare organizations are more motivated to replace manual, paper-based processes with a complete digital solution. Laura Palmer, a senior industry analyst with the Medical Group Management Association commented in a 2014 Medical Economics article, “I would expect to see a multitude of denied charges for coding and billing errors when the industry changes to ICD-10 on October 1, 2015. When diagnosis codes change to more specific coding, there may be mismatches with medical necessity and provider payment guidelines. Payers have not changed or may not have released their payment determinations for the new codes.”

To address these challenges, ICD-10 compliant software solutions are entering the market that can help payers automatically process institutional and professional medical claims and supporting documents. These systems can capture, extract and validate all patient, provider and service line data from medical bills, including identifying invalid medical codes.

By speeding the identification of problematic claims and resolution with providers, claims validation workers can make more informed decisions about the next appropriate action to expedite the transition of “clean claims” and corrected claims into the downstream adjudication process. This type of operational efficiency will significantly reduce the cost of claims and speed reimbursements. 

Finally, implementing document capture technology will enable both payers and providers to better comply with security and privacy regulations in all processes and systems utilized throughout the revenue cycle.

Digitization of data resulting from collecting, transforming, validating and automatically moving patient, clinical and billing data from documents into workflows that promote low human touch, not only helps healthcare and insurance organizations achieve efficiencies and drive out costs, it does so with improved compliance and transparency.

Jeff Meyers is a Product Marketing Director at Lexmark