Case Study

Dentegra Group Improves Claims Processing Efficiency

Source: OPEX Corporation
Dentegra Group Improves Claims Processing Efficiency

An Intelligent Scanning Solution from OPEX & Mavro Imaging has eliminated manual sorting and filing and improved claims adjudication.

Insurance claims processing is a complex endeavor, and for companies that manually manage the incoming documents, it is very time-consuming. Dental claims include a number of different forms, supporting documentation and patient X-rays, all of which must be properly classified, sorted, scanned and filed.

Dentegra Group, Inc., one of the country’s largest dental benefits delivery systems, serves enrollees in both commercial and government-sponsored programs. For years prior, the company utilized OPEX Rapid Extraction Desks® to open envelopes. Once the envelopes were opened, the contents of the envelopes were manually sorted before the tens of thousands of claims were processed on separate document scanners.

Reliable, But Not Automated.

Dentegra’s commercial claims operation processed as many as 50,000 claims each day, so manually sorting that paperwork and the included X-rays had been an arduous and time-consuming process. Sorting involved multiple steps, including sequencing, verifiying of information and adding barcode labels.

Scanning the documents required taping anything smaller than an 81/2- by 11-inch document onto a carrier sheet and inserting separator sheets to define transaction breaks in the scanning workflow. High-resolution X-ray prints and film X-rays that arrived were handled via a separate filing process.