New integrated capture and audit solution drastically improves finances for medial insurers

Waltham, MA – AliusDoc, LLC and ARC Healthcare Technologies (ARC) have partnered to offer an integrated data capture and audit solution that delivers tremendous value to medical insurers when reviewing itemized medical bills related to UB 04 claims.

Payers devote valuable human capital to review, record, and negotiate the long list of charges on itemized bills. Due to complexity and length, there are frequent errors or overcharges amounting to as much as 25% of the total bill. Finding these errors involves scarce, highly skilled and expensive staff. Because it can take days to review a single, complex itemized bill against insurance plan contract coverage, many bills are often not reviewed at all.

Rich Caproni, AliusDoc’s Director of Strategy and Business Development notes, “The power of ARC’s audit engine allows payers to review several times the number of charges with a fraction of the human resources. …And the deep knowledge of the ARC team makes the transition quick and seamless resulting in quick and substantial ROI.”

AD-I-Bills expedites the capture of all relevant data and routes it to ARC’s powerful audit engine to identify and sort potential overages/errors per client specifications. The solution then automatically generates the report to be sent to the billing provider.

As a result, payers are able to review more charges in a fraction of the time, reduce human error in both the search and recording of erroneous charges, contest far more erroneous charges, and capture a wealth of data for valuable analytics of costs across care providers, policies geographies and demographics.

ARC assessed multiple alternative solutions for capturing data from itemized bills before discovering the superiority of AliusDoc solutions for capturing data from unstructured and semi-structured documents. ARC Review Systems CEO, Todd Hill, commented, “After spending months working with the more wellknown names in the capture business, we quickly recognized the advantages of AliusDoc’s solution. Thanks to their highly experienced and responsive team, AD-I-Bills was implemented quickly and with great results”.

An example of value delivered can be taken from a top-ten insurer that uses Registered Nurses (RNs) to manually review itemized bills. An assessment of the payer’s current process revealed that:

• Only patient bills that exceeded $50,000 are reviewed
• All identified items are manually entered into the database by the RN
• The report sent back to the hospital in order to refute the bill is developed manually

For a sizable itemized bill, this process would take several days of the RN’s time, include data entry errors and have multiple erroneous charges being missed.

By using AD-I-Bills and ARC Review Systems, the process and results are as follows:

• All charges are reviewed (desired benchmark is set by the client)
• Significantly more erroneous charges identified
• Human errors in identifying and recording erroneous are eliminated
• Reports of refuted charges are automatically generated, reducing staff time and avoiding human error
• Overall time to process and refute the itemized bill reduced by as much as ten times
• Time spent by RNs reduced by as much as ten times
• A wealth of valuable data delivered for analytics across multiple corporate functions of the payer

About AliusDoc
AliusDoc offers forms processing solutions as well as professional consulting services and business process outsourcing to the healthcare, financial government, and professional services industries. For more information, visit us at www.aliusdoc.com or email InfoRequests@aliusdoc.com. AliusDoc was founded in 2005 by industry veterans with over fifty combined years of experience in document imaging, data capture, I/OCR technologies, forms design and document processing workflows. AliusDoc solutions and staff leverage hands-on knowledge from implementing hundreds of forms processing solutions.

About ARC Healthcare Technologies
ARC Healthcare Technologies provides business intelligence applications and consulting services designed to help payer organizations reign in wasteful spending. ARC’s UB Editor application reduces the time required to audit large facility bills by as much as 95%. The reduction in operational costs is accompanied by improved consistency and accuracy of claim auditing. The application also offers other powerful built-in functionality including automated and manual identification of claim charges for denial, team collaboration tools for collective input from auditors or departments, and detailed reporting to show impact as well as trending. For more information visit www.archct.com or email toddh@arcreviews.com.