Insurance payors in the U.S. shell out $60 billion in fraudulent claims every year. It’s vital to protect your company against this liability. Over the past 12 years, Vee Technologies USA has created systems and processes to help protect you again insurance claims fraud.
Provider & Fee Schedule Matching
Provider matching is one of the most complicated obstacles facing claims managers. A mistaken provider match can result in incorrect payment. Our provider matching process is prepared by using sophisticated provider matching algorithms to elevate the accuracy and the "hit rate" of your match, while removing the cost and errors associated with manual matches. Vee Technologies USA continuously boosts the quality of its insurance fraud detection services and offers a cost effective solution for insurance companies. In-turn, this creates the following reimbursements for claim operations:
- Improved Payment Accuracy
- Lower Cost
- Shortened Turn Around
Multiple fields can be compared against the physician's database to provide a selection based on a refined data search. This is done at the time of validation. The physician TIN (tax ID numbers) and other information may be included, even if it’s not part of the information found on the HCFA form.
City, state, zip, area code, common first and last names as well as professional titles and institutions can also be validated. These databases may be used to validate fields on a form or automatically fill partial records with complete data. Context sensitive spell checking increases accuracy and reduces validation operator interaction. All standard and custom databases may be modified to reflect the demographics of each client or claims site.
Intelligent Extraction of HCFA 1500 Field 33 Data
Facility name, provider name (first and last), phone number, street address, city, state, and zip code may also be extracted for intelligent validation. All, none, or any subset of these data items may be present on the form in any order. The intelligent extraction feature utilizes extensive databases and matching algorithms to automatically place recognized data into the proper discrete fields of your database.