Dental Claims Processing Service
The Next Evolution Is Here
From Paper to EDI: On-Shore Quality & Security with Off-Shore Pricing
If you would like to outsource the headache of paper dental claims processing and x-ray scanning with output to EDI in 837D format, you’ve come to the right place.
We have extensive claims scanning and processing experience and always operate with SOC 2 and HIPAA compliance measures in place. We utilize our own ICS Dental Claims Processing Software, which is an automated, high-volume claims form capture and processing solution built on the OpenText Intelligent Capture (Captiva) platform. Our Dental claims processing services allows ICS to process claims with data accuracy rates of greater than 98% and turnaround times to meet your organization’s needs.
Our facility is completely secure, with 24/7 video surveillance, monitored/secure entry, with burglar/fire suppression and monitoring. ICS is also a SOC 2 Type 2 compliant organization.
No one processes dental claims faster or with higher quality than ICS.
The Process
Mailroom Intake
ICS has the ability to handle all incoming claim types and correspondence EOB/COBs, attachments, X-rays, appeals, faxes, email, and even non-standard forms.
Claim Tracking
We track every paper claim, attachment (COB, EOB, Chart, Etc.), and x-ray from the time they are received in the mailroom through to EDI output.
Scanning
ICS utilizes ultra-high-speed scanning to digitize all claims and attachments. The ability to incorporate in-line barcode reads at scan time allows ICS speed up document processing times and reduce the number of manual mailroom sorts.
X-Ray Scanning
ICS utilizes a backlit scanning station to handle all radiograph x-rays. ICS can scan x-rays at a diagnostic quality and automatically attach these images to your claim so the transaction exports as one cohesive document.
Claim Data Capture
Using our capture process, the complete dental form is optimized for OCR data capture.
Business Rules
Every field on a claim can be customized to meet each insurance payer’s need for how they require the data to be processed. The implementation of business rules ensures cleaner data is transmitted into your adjudication system and backend business processing. ICS works with each customer individually to understand how they expect the data to be captured and exported. We customize each claim’s capture job to meet the needs of our customer, we understand no two insurance payers processing claims exactly the same.
Member & Provider Matching
Mismatched member and provider data are a leading cause of claim rejections for many payers. ICS provides member and provider matching logic which compares the claim data to a payer’s extract files to validate the data in real time as the claim is being processed. This ensure the data is valid and formatted correctly to be ingested by your adjudication system, thus reducing the number of pending claims and increasing auto-adjudication rates.
Claim Export
ICS works with each client to customize an 837D to be automatically ingested by their backend claim adjudication system. This allows claim data to be automatically processed and reduce the number of claim touchpoints for the client reducing the overall cost of processing claims.