Healthcare Case Study

The Situation:

A National Healthcare company was maintaining all of their Claim Files on paper. The claims were boxed by name of the claims processor and date they were processed. The claims were stored on rack shelving in the company's storage facility by the date the claim was processed. The company was notified they were going to be audited in four months and asked to produce specific claims by name, SSN#, or State of Insured. Since the claim files were not stored this way and they had 1.75 million claims, they knew they had a problem. Also, one of their sister companies had just been audited for their claim files and were dealt a healthy fine for not being able to produce specific files.

The Solution:

Pick up 100 boxes each week for 14 weeks to complete the project before the audit. Scan each claim file to a multi-paged PDF. Create a database for the audit of the Name, SSN#, State of Insured, and Claim Number. Batches of scanned claim files and database are securely transferred and uploaded into the Optiscan eVista Document Management software where access is restricted for only employees authorized to view the claim files.

The Benefits:

• Completed the project well in advance of the audit.
• Immediate access to any claim file
• Vastly improved customer service
• Eliminated the time to search for and re-file requested claim files
• Disaster recovery back up of all claim files
• Gained much needed storage space where claim files were kept