Medical claims processing
Ability to process UB04 and NUCC forms, processing 8 million medical claim pages per month, identification rate for UB04s grew from zero to 85-90 percent
|Headquarters||Salt Lake City , Utah|
|Products and Services||ABBYY FineReader Engine SDK with FlexiCapture Module and Artsyl ClaimAction|
”ABBYY tends to be more accurate. For clients that pay for better accuracy, it’s a better solution.”
Director of Engineering, FVTech
FVTech, based in Salt Lake City, is a Business Process Outsourcing provider, specializing in solutions for document imaging, digital conversion, and workflow management capabilities to its clients in the healthcare, insurance, manufacturing, mortgage, retail/distribution, and transportation industries.
One of FVTech’s primary focuses is in medical claims processing. When the company revamped its technology for this division, it called on FVTech’s Director of Engineering, Jose Dias to lead the charge.
As an 11-year technical veteran in the medical claims imaging and capture space, Dias knew exactly what he wanted in the new data capture solution.
“We were moving from a legacy system to our own proprietary platform,” said Dias. “Our previous system was limited in terms of new capabilities; UB04 forms were not supported and NUCC had marginal support. We looked to bring these and other capabilities to our new platform. We considered the amount of effort to build these templates from scratch but concluded it was better to license and leverage an existing technology,” he said.
The company had already been using ABBYY FineReader Engine SDK with FlexiCapture module for about two years in their proprietary platform. When FVTech needed a solution to automate identification of forms and data extraction for medical bills, they turned to their ABBYY Value-Added Reseller, Artsyl and its ClaimAction medical claims processing solution.
“I knew the identification and extraction problem was not a simple, trivial problem to solve,” said Dias. “Given our past experiences with Artsyl’s services and support and knowing what their engineering team was capable of, we were confi dent that Artsyl had the right solution.”
Before settling on the ABBYY-Artsyl solution however, Dias looked into several other existing technologies in the industry, but found they were restricted in one way or another. “As a BPO organization, we need to be very flexible,” said Dias. “We need to provide solutions to our clients without any push back, and we need the same flexibility from our vendors,” he said.
Dias and his group conducted rigorous regression testing with ClaimAction using existing test sets with known problems so that they could test the product against a baseline. “We evaluated the product and evaluated it against existing systems and found that the performance results were comparable to or exceeded the other solutions that were out there,” he said.
Dias worked directly with Artur Vassylyev, Artsyl Founder and Director of Engineering to modify the ABBYY-Artsyl solution to make sure it worked well within his system to ensure the automatic identification and data extraction of his company’s medical claims business. Dias said ABBYY tends to be more accurate,” he said. “For clients that pay for better accuracy, it’s a better solution.”
“It was easy to work with Jose, as he takes this project as very, very important so he was very good to work with,” said Artur Vassylyev, Artsyl Founder and Director of Engineering, who worked with FVTech. “Jose wanted deeper control of the overall system, so we worked with him to customize the solution to his specifications,” said Vassylyev.
Using ABBYY FineReader Engine with FlexiCapture module as their runtime, and Artsyl ClaimAction as the definition, FVTech’s first client was in production within a few months. They’ve successfully been using their solution to process approximately 2 million medical claims, containing 8 million pages a month.
FVTech’s identification rate for UB04s has grown from zero percent to 85 or 90 percent, according to Dias.
“Artsyl’s been very supportive and responsive to our needs,” said Dias. “It’s been a pleasure to work with them. They were accommodating in working with us to resolve issues with the solution and were specific to our requirements; they’ve been very responsive and very adaptive in making it work for us.”
ABBYY is a leading global provider of technologies and solutions that help businesses to action information. The company sets the standard in content capture and innovative language-based technologies that integrate across the information lifecycle. ABBYY solutions are relied on to optimize business processes, mitigate risk, accelerate decision making and drive revenue. ABBYY technologies are used and licensed by some of the largest international enterprises and government organizations, as well as SMBs and individuals. The company maintains offices in Australia, Canada, Cyprus, France, Germany, Japan, Russia, Spain, Taiwan, the UAE, the UK, Ukraine, and the United States. For more information, visit Key Facts.