Our Healthcare Claims Processing Solution is a uniquely engineered test data set put into systems as a testing method and a set of analytical tools to analyze the output results. The data set is comprised of millions of representative claims records in EDI file format, that is essentially a descriptive sample set of trillions of files and population statistics, with business rules incorporated. This test data set allows systems to be tested digitally instead of the current manual labor method or use of confidential production data.
This method has several advantages:
- Eliminates the need for inspection
- Eliminates risks associated with HIPAA confidentiality law non-compliance
- Allows for root-cause error analysis
- Most importantly, it greatly reduces error by using mechanical instead of human labor
The manual labor error rate is about 2%-3%; use of the digital test set has the potential of reducing system errors by 50% or to 1%-1.5%. Given the cost associated with error, this kind of reduction in error rate has the capacity to save providers millions of dollars, while reducing the risk of HIPAA law non-compliance.