Case Study

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Dental Claims Processing Case Study

Dental Claims Payer in New Jersey



ICS worked with a large dental claims payer in New Jersey with the following challenge:


  • Replace an RRI data capture system specifically designed for dental claims, in place for over 10 years, but outdated and inefficient
  • Despite its drawbacks, the legacy system had been customized over the years and had become an integral part of day to day business
  • Customer is SSAE16 certified with extremely challenging requirements around change management, security, reporting, and daily reconciliation of all incoming claims vs. exported and archived claims
  • Requirement to track operator productivity, claims in each work queue, and ability to launch any queue from a single point



After implementing ICS Dental Claims Processing Software, the client has realized significant efficiencies:


  • The ICS solution is now capturing over 8,000 forms a day
  • ICS able to identify 3 different ADA forms and 29 different templates of these “standard” forms
  • System now able to classify 80% of all paper claims received
  • ICS also able to automatically perform “Black Line Dropout” along with standard Image enhancement to prepare the images for the auto extraction steps to follow
  • Now capturing close to 90% of all data off of hundreds of variations of a black dental form
  • Entire workflow and productivity metrics now highly monitored

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