Reconciliation Root Canal: The Functional Impact of Form Automation

According to the American Dental Association (ADA), annual gross billings for dental generalists topped $700,000 in 2017, while specialists billed more than $1,000,000. The challenge? Ensuring digital claim forms are properly completed and double-checked before they’re sent to insurance providers to streamline clinic payments.

This process — known as reconciliation — is critical to ensure accuracy, prevent fraud, and reduce overbilling. But like a root canal, it’s also time consuming and potentially painful for office staff to complete, especially as the sheer volume of digital data increases. The solution? Intelligent form automation that improves functional impact and reduces human error in reconciliation.

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The Truth About Human Error

Despite best efforts, humans make mistakes — especially when it comes to data entry and analysis. Rising stress levels and high workloads increase the rate of error in healthcare. As noted by Fortune, 14 percent of medical professionals said workload burnout led to making “errors I might not ordinarily make” when entering data required for EHRs or claim forms.

Intelligent form automation with Accusoft’s forms processing SDK can help solve this problem by deploying a combination of intelligent character recognition (ICR) and optical mark recognition (OMR). From checkboxes to handwritten descriptions and typed procedure codes, ICR/OMR capable offerings can both verify accuracy and capture physical data, in turn reducing the amount of claim revisions and rejections.

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Checking Every Box

A typical adult can read approximately 300 words per minute, which is about the length of an average claims form. The result? One staff member could evaluate 60 forms per hour and 480 per eight-hour day if they took no breaks and made no mistakes.

The problem? This is impossible even under ideal circumstances, especially when they have to cross-reference forms and procedures to ensure boxes are properly checked and fees are properly assessed. Add in the fact that many large providers now handle thousands of claims per day and it’s clear that manually processing the forms isn’t conducive to productivity.

However there are forms automation tools that are capable of accurately reading one form every second. And while they require reasonably-sized budget allocations, they’re far more cost-efficient than hiring multiple staff to check — and double-check — dental claim forms.

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It All Adds Up

Reconciliation also poses the problem of storage. While a forms processing SDK has limitless transaction capacity, the sheer volume of digital data can quickly overwhelm even tech-savvy healthcare firms. This data can’t be deleted. As noted by HIT Consultant, the shift to digital patient data is critical to provide accurate treatment on-demand, and companies are also required to maintain auditable trails of information in the event of compliance evaluations or legal challenges.

Dental insurance claims demand rigorous double-checks to ensure procedures match expected payments. Don’t bite off more than you can chew. Increase accuracy, boost throughput and manage rising storage requirements with FormSuite for Structured Forms.