United Healthcare Corporation Readies for the Revolution with OCR for Forms

Many managed healthcare firms believe a revolution is taking place in the marketplace. The consumers they serve demonstrate a newly deepened belief that each individual controls his or her destiny-and expect choice and exceptional service from their healthcare providers.

United Healthcare is a leader among leaders in the managed care profession, cited by Forbes magazine as the most-admired company in the health services field. The company recognized early the significance of internal data processing applications that ultimately streamline the delivery of consumer satisfaction. With more than 8.5 million insured customers across 40 states, United Healthcare was receiving more than 10,000 HCFA (Health Care Finance Administration) forms daily for consumers covered by Medicare or Medicaid.

The organization had been processing HCFA forms in a manner typical for health care insurers. Forms were received, sorted into batches, and microfilmed at a central inventory control location. Batched forms were shipped to the appropriate processing department where claims processors manually entered the HCFA forms into the claims system. In this set-up, United Healthcare could process 55 claims per person, per hour. If a paper copy was required at a later date, an inventory control staffer would retrieve and print the document from microfilm.

Given the high volume of forms processed, typically 10,000 per day, United Healthcare quickly recognized that any improvement in productivity would translate into significant cost-savings for the company. Further, in the increasing competition for managed healthcare services, any reduction in turnaround time could improve customer service and be a competitive advantage for the company.

United Healthcare chose OCR for Forms from Microsystems Technology, Inc. after a competitive search. Members of the IT team had previous experience with the product and felt it presented a robust solution with a strong value proposition. United Healthcare implemented a system in which claims are scanned into a three-tier client/server Sybase applications front-end called CPW. This front-end also provides integrated imaging workplan management. OCR for Forms data is later transferred to the United Healthcare's Unisys mainframe application, COSMOS.

United Healthcare's OCR for Forms application quickly led to significant cost-savings and improvements in turn-around times. United Healthcare calculated cost-savings of $0.163 per claim with OCR for Forms-or $300,00 to $500,000 annually. Scanning, rather than microfilming, a document saved time. So did the ability to retrieve and print forms directly from the Unisys mainframe, rather than from microfilm. Automating the data entry function with OCR for Forms also allowed staffing levels to be reduced at United Healthcare's inventory control center. Another plus: OCR for Forms also shaved a full day off turnaround time-with no reduction in accuracy standards and results.

In fact, OCR for Forms was seen as such a success that the organization intends to expand its use of the software to include new claims types and apply OCR for Forms at other health care businesses within its parent, UnitedHealth Group.