Provider and Fee Schedule Matching
Provider matching is one of the most difficult challenges facing claims managers. An incorrect provider match can result in incorrect payment. VeeInsure’s provider matching
process
is done by utilizing sophisticated provider matching algorithms to improve accuracy and the "hit rate" of your match while eliminating the cost and errors associated with manual matches. This, in-turn, facilitates the following benefits for claim operations:
Improved Payment Accuracy
Lower Cost
Shortened Turn Around
Provider Selection
Multiple fields can be compared against the physician's database to provide a selection based on a refined search of data. This is done at the time of validation. The physician TIN (Tax ID Numbers) numbers and other information may be included, even if it’s not part of the information found on the HCFA form.
Database Validation
City , State, Zip, Area code, common first and last names as well as professional titles and institutions can also be validated. These databases may be used to validate fields on a form or automatically fill partial records with complete data. Context sensitive spell checking increases accuracy and reduces validation operator interaction. All standard and custom databases may be modified to reflect the demographics of each client or claims site.
Intelligent Extraction of HCFA 1500 Field 33 data
Facility name, provider name (first and last), phone number, street address, city, state, and zip code may also be extracted for intelligent validation. All, none, or any subset of these data items may be present on the form in any order. The Intelligent extraction feature makes use of extensive databases and matching algorithms to automatically place recognized data into the proper discrete fields of your database.
Vee will be happy to answer your questions and discuss over a call. Please contact us on 1-877-794-9514 or email at clientservices@veeinsure.com
