Health Insurance Fraud Detection Services:

Veeinsure's Forms Processing system will ensure the accuracy of claims by maintaining accuracy at different parts. 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. This process simultaneously eliminates the cost and errors associated with manual matches; in-turn, this 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 is 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 interaction by a validation operator. 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.

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