Diversified is fully HIPAA-compliant.
A major healthcare insurance company, ranked among the top three in the U.S., had 14 regional mail processing centers handling incoming claims, correspondence and checks. Faced with enormous overhead, staffing requirements and varying processing standards, the company elected to consolidate this function with Diversified Information Technologies.
All mail was re-routed to Diversified, where it is retrieved from the USPS regional distribution center every two hours, Monday–Saturday. Barcode technology was incorporated into the process to track each mail container and verify turnaround times.
Once all correspondence is extracted, documents are sorted into categories and prepped for scanning, including removing staples, mending tears and inserting file separation sheets. Then the documents are imaged via high-speed production scanners. An image audit of each batch ensures that all electronic files are present and readable.
After imaging, data from the files is captured by using a double-blind entry system. Finally, data is validated against client-specific tables, allowing up to 70 percent of the claims to be auto-adjudicated.
The final step in this process is exporting the electronic data and images into the client’s workflow system.
By outsourcing their mailroom and claims processing systems to Diversified, the customer reports cost savings in the following areas:
§ Higher auto-adjudication rates result in lower processing costs
§ Improved turnaround times lessen state-imposed penalties for slow claims payment
§ Consolidation of facilities lowers overhead and operations costs
Diversified currently processes more than 750,000 claims per week for this one client, or more than 70 million claims yearly. The client’s specified turnaround time of 24 hours is consistently exceeded, and data-extraction accuracy rates of 99 percent are well above industry standards, and significantly higher than the nearest competitor.