How to Transform CMS Form Data Extraction with Intelligent Document Processing for Healthcare

The healthcare world is constantly evolving, making efficient data management more critical than ever.  

And if you’re like most healthcare providers, one of your most standout challenges is the extraction of vital information from Centers for Medicare & Medicaid Services (CMS) forms like:  

• CMS 10114 

• CMS 1490S 

• CMS 1763 

• CMS 20027 

• CMS 40B 

• CMS L564 

• CMS R-131 

This problem is widespread, as healthcare organizations everywhere are regularly inundated with these CMS forms, each with their own unique layout and data fields.  

For most organizations, this means manual data extraction, which is extremely time-consuming, inefficient, and error prone. You’ve likely had to manage the consequences of these errors yourself, too, ranging from compliance issues to payment delays and hindered patient care.  

With stakes like these, it’s clear that an accurate, streamlined data extraction solution is sorely needed. 

To tackle this challenge, many organizations are turning to intelligent document processing (IDP) solutions like ABBYY Vantage. This technology enables healthcare providers to extract data from their CMS forms quickly, securely, and accurately.  

This blog will take a deep dive into this promising solution. We’ll explore how it works, the benefits it can provide, and the different ways healthcare providers like you are using it to solve common challenges. Lastly, we’ll cover a quick case study to observe how this technology played out for one healthcare organization.  

How to Transform CMS Form Data Extraction with Intelligent Document Processing for Healthcare

How it Works: Intelligent Document Processing for Healthcare 

IDP solutions like ABBYY Vantage employ a multi-faceted approach to CMS form data extraction: 

• OCR Technology: Optical Character Recognition technology scans CMS forms to identify text and numbers, converting them into machine-readable data. 

• NLP and Machine Learning: Natural Language Processing and machine learning algorithms are used to understand and interpret the context of the extracted data. This enables ABBYY Vantage to accurately identify and classify various data fields on CMS forms. 

• Data Verification: The solution cross-references the extracted data with predefined rules and validations, ensuring accuracy and compliance with CMS requirements. 

One of the key strengths of IDP solutions is their ability to be customized to meet the specific needs of healthcare organizations. It offers customization capabilities like: 

• Template Creation: ABBYY Vantage allows for the creation of templates for specific CMS forms. These templates define the location of data fields on the form and the expected data types, making it highly adaptable to various form layouts. 
• Rule-Based Validation: Healthcare organizations can define rules and validations to ensure the extracted data aligns with the CMS regulations. Custom rules can be set up to flag discrepancies or anomalies for review. 
• Integration with EHR/EMR Systems: ABBYY Vantage seamlessly integrates with Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems, ensuring that the extracted CMS data is directly incorporated into patient records. 

Top 7 Benefits of Intelligent Document Processing for Healthcare 

Now that we understand how IDP works, here are some benefits it can offer healthcare providers: 

1. Template Flexibility: As we already touched on, IDP is highly flexible when it comes to templates. In fact, its template-free approach means it can adapt to various CMS form layouts, including CMS 10114, CMS 1490S, CMS 1763, CMS 20027, CMS 40B, CMS L564, and CMS R-131. This adaptability ensures that no matter the form, your data extraction needs are met. 
2. High Accuracy: IDP’s intelligent algorithms ensure a high level of accuracy in data extraction, enhancing the accuracy of your billing, compliance, and patient care processes. And less manual data correction means you get valuable time and resources back in your pocket. 
3. Scalability: Whether your organization deals with a few forms or thousands, IDP solutions like ABBYY Vantage scale effortlessly to handle your data extraction demands, making it suitable for healthcare providers of all sizes. 
4. Integration: IDP solutions like ABBYY Vantage are designed with integration as a priority, allowing them to seamlessly integrate with your existing systems and workflows. This ensures a smooth transition to automated data extraction without requiring any kind of tech stack overhaul or modernization projects that could disrupt your operations. Instead, you can solve your CMS data extraction challenge while maintaining business as usual. 
5. Time Savings: Reduces the time spent on data extraction by minimizing manual data extraction and allows your staff to focus their time on more valuable activities. 
6. Cost-Efficiency: It streamlines data extraction to reduce operational costs associated with manual processes and errors. 
7. Compliance Assurance: It increases the rate of compliance with CMS regulations and reduces the risk of penalties by providing accurate and consistent data extraction. 

Thanks to IDP solutions like ABBYY Vantage’s versatility, healthcare providers typically expand their solution to cover other use cases, like: 

Additional Use Cases: 

• Claims Processing: IDP expedites claims processing by extracting critical patient and provider information from CMS forms, reducing payment delays. 

• Compliance Reporting: Ensure compliance with CMS regulations by automating the extraction of required data for reporting purposes. 

• Patient Data Entry: Streamline patient data entry into EHR systems by extracting information from CMS forms like CMS L564 and CMS R-131. 

• Quality Assurance: Identify and rectify data discrepancies early in the process, reducing errors and improving data quality. 

Now let’s take a look at an example of this technology in action through the experience of one healthcare processing company in the US: 

Intelligent Document Processing Use Case: A Healthcare Processing Company’s Story 

We always enjoy sharing the unique stories of the organizations we work with here at Naviant. Here’s one that effectively demonstrates what IDP for healthcare can look like in the real world: 

The Challenge 

A US healthcare firm was struggling with time-consuming manual data entry for CMS 1500 forms, which are essential for medical claim processing. The process was error-prone and led to issues with: 

• Patient enrollment
• Billing
• Unnecessary claim denials
• Growing backlog

The firm decided to implement medical billing automation using ABBYY Vantage. 

The Solution: 

The firm implemented ABBYY Vantage, the industry leading OCR and intelligent document processing solution, configured to handle CMS 1500 forms. The platform accurately extracted patient information, reducing data entry time by 80%. Also, rule-based validations ensured compliance with CMS guidelines. 

The Results: 

• Claim entry time reduced from days to minutes. 
• Billing accuracy improved and reduced revenue cycle bottlenecks. 
• Improved efficiency allowed the claim department to handle a higher volume of claims with the same staff, thus reducing the backlog and improving the overall operational efficiency. 
• Enhanced the patient experience with faster claims processing and allowed patients to receive accurate bills sooner, which ultimately enhanced their satisfaction with the healthcare practice.

Invest in Your Future Today 

Solving your CMS form data extraction challenge by investing in IDP is an investment in your future. It’s a strategic move that positions healthcare providers to confidently navigate the complexities of data management in a digital era. And the benefits it provides won’t just make your team’s work lives easier and help your organization thrive – it’ll help you provide a better patient experience, too.  

Want guidance on how to get started? Drop a question or comment in the chat below. We’d love to hear from you. 

Looking to see ABBYY Vantage in action? We’ve got a full library with ABBYY-focused video guides – Access it here.