A number of older practice management and billing systems used by physicians, hospitals and dental practices are not able to generate ANSI 837 billing files(for electronic transmission) to insurance companies and other payers. Receiving paper is clumsy, inefficient and expensive. RevenueMed’s RevClaim™ solution offers a way of outsourcing this function so that every in-bound claim behaves like a native 837 transaction.

Insurers simply scan the paper claims (generally via their lockbox operator) and transmit these to RevenueMed via secure FTP. We’ll convert these reliably and accurately to 837 files and transmit back to the insurer for upload into its payment processing and claims adjudication software. When compared with in-house operations or even working with other outsourcing companies, RevenueMed’s solution is more reliable, scalable and generally lower cost.

Some vendors claim to have a fully-automated solution, but in practice technologies like optical character recognition (OCR) are not an acceptable stand-alone solution for converting paper claims to usable, structured data. Variations in scanning quality, skewed forms and other factors simply limit the ability of software to read forms perfectly without human checks and balances.

In contrast to the other services available in the market, the RevClaim solution combines bestof-breed software tools for OCR, workflow and denials mapping with an affordable and highly trained offshore workforce. The combination of these service components yields an offering that is distinctly efficient, reliable and low-maintenance for our customers, while also ensuring that the data being fed into claims processing systems is highly accurate.