Claims Processing “Un-Touched” Rate of 16% Achieved

Claims Processing “Un-Touched” Rate of 16% Achieved

For one of the five Delta Dental affiliates we work with, we’ve recently doubled our “un-touched” rate from 8% to 16%.

Also referred to as “straight-through processing,” un-touched rate refers to the ability to process a paper dental claim without the need for human intervention. This includes achieving 100% optical character recognition (OCR) rates and with 84% of claims meeting business rules (which will vary per organization).

It’s important to note that this un-touched rate was achieved in preliminary testing, following our upgrade of their document scanning and capture software, EMC Captiva, from version 6.5 to 7.1. Our next step is to release Captiva 7.1 into production and see what un-touched rates are achieved then.

Regardless, this is encouraging as it can save our clients thousands of dollars per day in increased productivity. Here’s the savings formula:

# of incoming claims per day x un-touched rate % x exception handler hourly rate $ x average # of hours for handling exceptions

If you plug in your own numbers, what do the savings look like for an un-touch rate of 8% to 16%? If they look good, let’s talk.

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