Additional Document Processing Services
In addition to claims processed by ClaimPRECISETM, GTESS has automated the processing of other healthcare and dental-related documents. These document types include Coordination of Benefits (COB) submitted with claims as well as other documents submitted to healthcare payers.
COB Processing
COB documents are processed through ClaimPRECISE via a group of internally developed technologies. A claim with an attachment is processed in conjunction with the Professional, Institutional or Dental claim submitted.
COB documents processed include:
- Explanation of Benefits (EOB)
- Explanation of Medicare Benefits (EOMB)
The following are a few of the fields captured via ClaimPRECISE from EOBs and EOMBs:
- Billed Amount
- Approved Amount
- Co-Insurance Amount
- Deductible Amount
- Paid Amount
- Reason Code
- HIC
Other Document Processing
GTESS has experience in capturing a wide-array of documents submitted to payers. Information from designated fields is captured and included in structured data files and returned to the client.
A sampling of Documents processed include:
- Non-Standard Claims
- Superbills
- Prescription Drug
- Repricing Documents
- Client-specific Claims Forms
- Government Sponsor Claim Forms
- Enrollment Forms
- Provider Contracts
- Specialized Form Processing
