The CMS 1500 Form, also known as the HCFA form, is an industry-standard form used for medical claims. It is federally regulated and required by Medicare. The general assumption for the CMS 1500 form is that it’s standardized—one form is used by everyone. But in reality, there’s no strict mandate to eliminate the use of older versions. Because of this, many providers continue to utilize older versions of the forms for convenience, each of which has 250+ data fields.
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While automation has gained more and more speed in recent years, many asset management firms continue to rely on spreadsheets for at least some of their operations. This spreadsheet dependence is often born through workarounds that are created when the normal IT channels aren’t able to meet needed deadlines. Spreadsheets can be perfectly functional tools, but their integration into daily processes can quickly become a problem by moving data away from core systems and introducing manual steps. These manual steps slow down the process and reduce efficiency, in addition to introducing greater potential for errors.
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Over the last two years, we’ve seen many businesses quickly adapting to a Work-from-Home (WFH) approach for their teams, lifting and shifting their current processes from a centralized office into a decentralized world.
While this was achieved for most businesses to varying degrees of success, it begs the question: are their current processes still the best way to go?
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Organizations are always looking for opportunities to execute faster, cheaper and more accurately, and continue to look to technology for help. Even so, many complex highly regulated businesses in banking, financial services, insurance and healthcare are often inhibited by legacy systems that lack flexibility or an ability to easily integrate, resulting in sustained, costly operations prone to high error rates.
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Designing and implementing superior processes supported by top technology may yield valuable business results, but taking a “set it and forget it” mentality can lead to process drift. The deterioration can be subtle and happen slowly, but over time erodes margins. Because that erosion is not noticeable until it reaches a level of emergency, the importance of preventative maintenance can get lost in the argument of “if we’re hitting our goals, everything is fine.” However, even small improvements can have a big impact and allow teams to not only hit goals but surpass them.
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Poor data accuracy rates, real-world data challenges like poor image quality and handwriting, and slow turnaround times are a constant source of frustration to COOs and CTOs alike—whether for new business workflows or back-office workflows servicing existing customers.
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Intelligent Document Processing (IDP) enables businesses to accept end-customer data in any form and turn the written word into actionable and decision-ready data.
Embedding AI in the front of your automation strategy means data is intelligently extracted and routed for decision making, and work is prioritized and contextualized based on data to fit directly into current business processes, improving every downstream workflow.
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Many organizations have accelerated their plans for digital transformation, driven largely by the COVID-19 pandemic and remote work conditions that appear to be the “new normal” moving forward. In the face of the “great resignation,” there is an increasing emphasis on and benefit from adapting to hybrid models of employees working both in the office and from home on a more permanent basis. The growth of those hybrid workforces is in turn driving the need for more efficiency. As a result, organizations are relying more heavily on process mining and AI to achieve their operational goals.
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