The CMS 1500 (formerly HCFA 1500) is the standard paper claim medical form used by non-institutional healthcare providers, such as private practices, to submit a claim for billing Medicare Fee-For-Service (FFS) Contractors for Part B covered services and some Medicaid-covered services. The CMS 1500 is sometimes also suitable for billing various government and some private insurers and is accepted by most health insurance providers. The CMS 1500 has been updated to include National Provider Identifiers (NPIs), or unique numbers required by HIPAA and contains all the basic information needed to submit an accurate claim. Before a claim is submitted, a number of technical protocols and industry standards must be met for insurance claims to be delivered expediently and accurately between medical practice and payer.
Perform all of your claims processing faster, with less errors and less effort
in one easy-to-use, affordable application.
The cutting-edge technology of our software
streamlines the processing of healthcare claims to offer
the leading innovative data management solution.
- Once the form is imported (copied or scanned) into our system, recognition begins:
Once the form is scanned, our software uses Optical Character Recognition (OCR) to recognize machine printed data from scanned images, as well as Intelligent Character Recognition (ICR) that can read hand printed data to electronically isolate and record information provided in the different fields, transferring and filling that information. This includes all information on the form, such as:
- Patient information
- Insurance information
- Each line of the services provided
- Account information
- Billing information
- Patient signatures
- Injury related dates
- Diagnosis codes
- Submission data
2. Our software checks for errors, then flags and prioritizes those errors.
Our software checks for errors, then flags and prioritizes those errors by low confidence fields for easy verification or correction. Low confidence areas are highlighted for fast review.
3. Edit or verify the recorded information.
You can review and edit all the data automatically recorded from the form.
4. The proper organization and format of the form is automatically generated
using a set of standards to meet the requirements mandated by the HIPAA Transactions and Code Set Rule (TCS) to allow for accurate claim submissions.
5. Export and store your claim.
When verification is complete, all the data is automatically exported to your claims processing system and stored in a database.
Does your organization enter data from healthcare claim forms?
You can benefit from our advanced automated processing system with its superior service-oriented architecture:
- Savings in time and labor
- Less errors caused by manual data entry
- Expedite claim processing and collection of payment
- Eliminate slow, inaccurate manual processes
- Easily meet changing healthcare industry standards
- Increase accuracy, productivity, and profitability
“For the past year, Community Eye Care has had the pleasure of partnering with ScanStore and ABBYY for our scanned claims functionality. The ABBYY software, combined with ScanStore’s technical expertise, has enabled us to scan 80% of the paper HCFA claims we receive every month. The scanning software has increased our productivity as well as our employee satisfaction and has eliminated the need to bring on additional staff for the foreseeable future.”