Fast, Accurate and Comprehensive Data Collection for Healthcare

Automates Insurance Claims
Medical claims processing is a demanding and expensive process for healthcare providers, carriers, agencies and payers. Manually keying patient and provider information, diagnosis and treatment codes and other critical data into acceptable database formats is time-consuming and prone to errors.

Cardiff MEDIclaim™ offers a more efficient and cost-effective automated solution that processes HCFA, UB-92 and non-regulated forms, as well as their document attachments. Leading TPA, HMO and PPO organizations have discovered that automated claims processing can be implemented quickly, leading to cost savings and improved customer service.

Cardiff MEDIclaim Business Benefits

• Increase through-put by 90-98% per form.
• Reduce processing costs by 50% - 90%.
• Eliminate form sorting through automatic form identification.
• Implement a single solution for forms and document attachments.
• Improve customer service through rapid data processing and online archive of completed forms.
• Rapid deployment and low cost-of-ownership results in ROI within months.
  

Cardiff MEDIclaim is based upon TELEform® Enterprise, the market-leading solution for integrated paper forms processing and document capture. MEDIclaim processes unsorted scanned and faxed forms, using powerful OCR and recognition capabilities to read and interpret typed and dot matrix printed information from HCFA-1500 and UB-92 forms. Working on a stand-alone PC or in a network environment, Cardiff MEDIclaim can be configured to meet the exact processing needs of your organization. Cardiff MEDIclaim features pre-configured form templates and business rules that speed implementation - new systems are often in production in a week. MEDIclaim includes pre-made Connect Agents to database and XML applications, and supports export customization to meet the data integrity and export formats specific to your organization.

Cardiff MEDIclaim Includes:

• TRI-CR - OCR/ICR/OMR/Barcode recognition with point & click business rules processing.
• Form Designer - Point & click implementation of non-standard forms and attachment.s
• Industry Standard Exports - ODBC, XML data exports; TIF and PDF image archive exports.
• Custom code validations - Including current ICD-9 and CPT 2001 tables.
• Cardiff MEDIclaim Verifier - Rapid processing of exceptions, double-key and key from image.
• Control Center - Load balancing, reporting and configuration of the networked system.

The Complete HCFA Solution
While it may take several weeks to receive reimbursement for a correctly coded claim, an incorrect claim may take months to resolve. By streamlining expensive and time-consuming coding process, Cardiff MEDIclaim improves claim payment turnaround time and increases data accuracy.

With Cardiff MEDIclaim, the process of reading, verifying, and exporting information from HCFA-1500 and UB-92 forms is fully automated. Medical claims can be processed in a fraction of the time required for manual data entry. Cardiff MEDIclaim can also be integrated with leading document management systems, automatically archiving completed forms and document attachments for customer service and HIPAA requirements.

Cardiff Software is committed to making your medical claims processing system a success. Our Consulting Services Division has the technical expertise and development experience necessary to analyze your requirements and create a complete medical claims processing solution. These dedicated professionals provide form design and configuration, application development, network configuration, system integration and complete project management.

Comprehensive training for your data entry staff is available at your site or one of our regional training centers. You will also receive expert priority support and quick answers to technical issues from Cardiff Software’s Technical Support Division.

• Updated ICD-9 and CPT® 2001 Tables

• Use the operating system wizard to find answers to specific OS compatibility questions
• Includes Secure Database with Administrator Control

Auto Set Purge and Batch Commit Settings
Allows the system administrator to set a specific time and day for a batch commit to execute. Found under the Utilities Configuration Reader Tab.
Use the pull down menu to select “Batch Commit.” Click on the Schedule button to set a time and date. The Purge setting is found under the Reader Utilities Purge Log Tab. Click on the Schedule button to set a time and date. These features are used to optimize system performance during periods of heavy verification. Now a system won’t be slowed down by a purge or commit running during processing hours. This enhancement has been requested by numerous service bureaus and high volume processing customers as a tool to increase their system throughput.

New and Enhanced Batch Handling Features
Allows multiple users on the same system to delete images from batches. Allows batch maintenance during both the correction and commit process. We are now able to create individual batch locks instead of a group batch lock. This capability will reduce error messages issued during verification and help to speed up processing. We also added an informational message that is issued when verifiers are waiting for batches to correct to let them know that there were “No Batches Found” while waiting for correction. We have had numerous customers request that we change the way the locking process worked because it was cumbersome.

Increase in Numeric Range Validations from 6 Digits to 12
Changes allow much more precise numeric range validations. We now have the ability to use 12 digits. The feature is accessed in the Designer via the Print Field Format and Validations tabs.

Remote Capture Option

• Allows TELEform Designers and Verifiers to work over a WAN utilizing Citrix MetaFrame System.
• Allows Remote Capture stations to scan and transmit images to a centralized data processing facility.
  

Software from Cardiff