Compmed Advantage - FEP Imaging

FEP IMAGING

Front-end Process (Scanning) and Online Claims Tool

In 1999, CompMed Partnership built a dedicated mailroom and scanning business unit in Tuscan, Arizona. By utilizing our scanning center, we can reduce mailroom costs at each of client’s branch offices. CompMed Partnership will set up a client-dedicated post office box and will provide notification to the providers of the mailing address. Additionally, the system can integrate with various scanning processes. CompMed Partnership has a number of clients that currently utilize data capture technologies such as scanning or OCR to input bill information, which is then sent electronically to the CompMed Partnership's proprietary Bill Review system via EDI.

CompMed Partnership sorts and scans the bills into the front-end scanning system. The scanner applies a Document Control Number (DCN) to all bills and their associated medical records for tracking purposes. CompMed Partnership’s systems support the storage of images in TIFF, PDF, HTML and JPEG formats. The default storage format is single page TIFF, predominantly for file size and portability of the image files.

Once the bills are scanned into the system they will be electronically routed, based on document type, to one of two areas: Optical Character Recognition (OCR) or keying documents from images (KFI) processing. Red-lined, machine-typed UB and HCFA bills documents qualify for OCR processing.

Black-lined documents and bills with handwritten instructions are routed to KFI processing. Nearly, 98% of all bills are scanned and ready for electronic transmission within three business days.

In addition, all mail is matched against client Claim File Header Information for validation by our Tucson office. The information is then sent electronically into our Online Claims Tool where it is segmented between assigned, unassigned or no match bills. For “no match” bills, the Online Claims Tool allows client users to electronically search the Injury Record database to match bills to the appropriate claim number when the Front End cannot make a unique match. Bills that are assigned or matched can be automated to go directly to bill review from the Online Claims Tool. client adjusters can access the information either before or after the bills have been reviewed.

The Online Claims Tool (OCT) provides an interface between our front-end process (scanning) and the CompMed Partnershipâ proprietary Bill Review system. client will have the option to access bills received on behalf of their claimants before or after they complete their route through the CompMed Partnershipâ Bill Review proprietary system. This allows for client specific edits, in addition to an automated payment and bill denial/reject process.

client will also be able to review medical records and completed Explanation Of Reviews (EORs) in our web enabled Records Repository that is part of the Online Claims Tool. Routing can be electronically completed from the Online Claims Tool to case management or other outside vendors based on specific bill criteria. client will have access to state of the art medical reports and savings information through this application.

In addition, CompMed Partnership can offer client the option of maintaining imaged documents internally while using our Records Repository as a back-up program. The Records Repository acts as a storage depot for information relevant to workers’ compensation injured workers and eliminates the need for second and third contacts with a provider to obtain medical information.

The Repository can accommodate files in one of three file formats TIFF, JPEG, and PDF. CompMed Partnership can retain images in the Records Repository for seven years at no additional cost to our clients. Once a document or image has exceeded the on-line storage time frame, we burn them to a platter for permanent storage.

All scanned pages of a document are stored and accessible in the imaging system through an interface using search indictors such as the Document Control Number, Bill ID, Claim Number, Patient Name, Social Security Number, Employer Name, Diagnosis, and Date of Injury. clients will be able to access/view images, query index data and print documents, which will be appropriately secured and restricted for privacy at no charge to client. The Records Repository becomes the place for clients to search for information submitted by providers. All documents that are stored/archived can be retrieved within 48 hours of a request from a client.

The Repository has been designed to support three levels of document security client Level, client Group Level and Document Level. These three levels should support client’s access requirements for bill and claim restrictions. User account administration is client delegated (CDA) and currently limited to top-level business entity ID. clients can only view their documents.

For Image Repository and Online Claims Tool, CompMed Partnership’s uptime percentage commitment is 99% or higher during our core business hours of Monday through Saturday from 7:00 a.m. to 9:00 p.m. EST. Our actual uptime was 99.5% for the past six months.

Electronic Data Interface

With over two decades of experience working with many of the industry leading companies, CompMed Partnership recognizes that each client has very specific requirements, including custom file formats. During the business requirements and implementation process, we will work with client to determine the types of inputs and outputs that will best suit your needs. The most common EDI connectivity options currently utilized between CompMed Partnership and our clients are the following:

Advantis Mailbox

Some of our clients that utilize the Advantis Mailbox have also installed a software package called “Compress” to compress and de-compress the file as it is sent and received through the mailbox. CompMed Partnership also uses this software.