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Medica Case4 Implemented Data Capture_Digital Intake.pptx

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Medica Case4 Implemented Data Capture_Digital Intake.pptx

  1. 1. © FIRSTSOURCE 2022 | CONFIDENTIAL I 7 February 2023 | 1 Implemented Data Capture Process for a Leading Health Plan in the US Client Objectives • The data capture process included three categories of bill types – Type 1 (65%), Type 2 (30%) and Type 3 (5%) • Quality SLAs: 97% for Type 1, 95% for Type 2 and 92% for Type 3 • Client needed a higher level of accuracy for Type 2 and Type 3 to improve the downstream claims processing Firstsource Solution • Firstsource studied the keyable claims process and introduced important error proofing, process control and standardization in the workflow • Applied stringent business rules and increased the confidence threshold on the OCR algorithm to prevent defects • Implemented new system interfaces: o Alerts and easier identification through different color coding schemes o Cross validation using databases such as city, state and zip code Business Outcomes • This initiative resulted in improving Type 2 accuracy levels from 95.6% to 96.4%. Similarly, Type-3 accuracy improved from 92.2% to 93.7% • Improved auto adjudication rates by 1 - 2% Leading Health Plan in the US 95.6% to 96.4% Accuracy improved $

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