The forms CMS 1500 (formerly HCFA 1500) and UB-04 are the most common medical forms used to submit a claim. The form CMS 1500 is the universal claim form used by non-institutional healthcare providers, such as private practices, to bill specific covered services. The form UB-04 is very similar to the CMS 1500, but it is used by institutional healthcare providers, such as hospitals, to submit claims. 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.
The insurance claims process presents a big data entry challenge.
Data from these forms must be entered into a claims processing system. This is an expensive, labor-intensive task that is also prone to transcription errors. Optical Character Recognition (OCR) software can be used to automate the data entry by converting the scanned forms into machine-readable text, while improving accuracy with data validation checks.