SolutionS
Document Management Solutions
Turn unstructured healthcare paperwork into reliable, searchable, compliant data.
Document Management captures, classifies, and secures high‑volume healthcare documents across intake channels including mail, fax, portals, and EDI attachments. Intelligent capture identifies document types, extracts key fields, and binds evidence to the right member, provider, and transaction so downstream teams can act without chasing files. Standardized templates and retention rules keep correspondence consistent and audit‑ready, while role‑based access and full version history protect PHI and simplify reviews.
The program integrates with claims, prior authorization, member services, and provider data workflows to eliminate manual handoffs. Status tracking and alerts prevent bottlenecks, and dashboards highlight throughput, turnaround time, exception rates, and rework drivers. Continuous improvement focuses on capture accuracy, queue prioritization, and exception reduction to shorten cycle times and reduce cost per document.
Omnichannel Capture
Ingest mail, fax, portal uploads, and EDI attachments, indexing each item to the right member, provider, and transaction.
Intelligent Classification & Extraction
Use model-driven document typing and field capture to cut manual keying and reduce error rates.
Evidence Binding & Traceability
Link supporting documents to claims, prior authorizations, appeals, and member records with complete audit history.
Standardized Correspondence
Generate notices and letters using governed templates, accurate reason codes, and required disclosures.
Secure Access & Governance
Apply role-based permissions, encryption, and retention policies aligned to HIPAA requirements.
Workflow & Exception Management
Route by priority and SLA, flag missing information, and resolve exceptions with clear ownership and timers.
Search & Retrieval
Retrieve member, provider, ID, date, or document type to accelerate reviews and responses.
Analytics & Continuous Improvement
Track throughput, turnaround time, exceptions, and rework to identify and execute process improvements.
Benefits
- Reduce manual handling and rework through accurate capture and classification.
- Shorten cycle times across claims, prior authorization, appeals, and member services.
- Improve compliance with governed templates, retention, and complete audit trails.
- Enhance data quality by binding evidence to the correct transaction and entity.
- Lower cost per document through automation and exception reduction.
- Increase operational visibility with real-time status and actionable metrics.
- Strengthen provider and member experience with faster, clearer responses.
- Scale to new volumes and document types with configurable workflows.