As value-based service models create higher document inventories and increased member enrollments become more demanding, manually intensive and paper-based tasks become a growing source of revenue loss, member dissatisfaction, as well as reputational, operational and compliance risk. Even processes based around electronic documents struggle to control costs and keep up or scale to meet rising claims and appeals, payment and reimbursement pressures, and correspondence and document demands of members, providers and regulators.
Powered by our flexible and scalable Sympraxis® Business Processing Management (BPM) platform and business solutions, we provide intelligent, data-driven mailroom and document services that give payers an edge in a complex industry. By optimizing processes with fewer touch points, we help improve operational efficiency and quality, reduce inventory management and costs, and ensure security and compliance while delivering a consistently positive customer experience.
Used by 5 of the top 10 U.S. health payers, our digital mailroom services handle more than 5 million digital transactions per month, from document receipt to secure, centralized data storage.
To meet your unique needs while adapting to changing state and federal requirements, our SympliMail services simplify and automate mailroom processing for all input types, whether they’re hard copies shipped to us by you, mail delivered to a dedicated P.O. box, or information provided to us in a variety of digital formats. In addition to hard copy, our Sympraxis® Document Capture electronically accepts documents via fax, FTP, email, CD/DVD sources, web and virtual printer server.
Our trained document management professionals process input by opening, batching and electronically sorting and imaging digital data. Each document is classified according to your rules and tracked with a unique bar code to ensure accuracy and security during processing and storage in an intelligent, centralized repository.
To further reduce the cost of scanning and digitization, SympliSend enables you to give providers an instantaneous and secure way of submitting appeals, medical records, attachments and other correspondence electronically. SympliSend guarantees document delivery and provides confirmations to the provider, ensuring total compliance and end-to-end transparency of document submissions on both sides.
Unlike traditional mailroom solutions, we prepare all documents electronically whether they are received in paper or digital format, which increases the speed of digitization and reduces errors. Our SymCapture data capture and EDI generation ensures highly efficient and precise document management. To further enhance speed and efficiency, our Sympraxis® Smart Classifier scans millions of pages every month and classifies documents into forms, letters and data, while our knowledgeable agents handle complex document coding using our smart wizard, classifier and hint tools.
From the very first document, our document management process is tailored to your needs. Through machine learning and artificial intelligence (AI), the process becomes even more efficient and customized over time. With each document processed, our auto-adaptive system becomes more intelligent and sensitive to your needs, able not only to manage documents efficiently, but to move claims through the system faster while meeting member needs more effectively.
With increased claims volumes and growing pressure to enhance quality come greater opportunities for error in manual processing. Robotic Process Automation (RPA) reduces both time spent on repetitive processes and the chance for human error. Intelligent, rule-driven, and working from a centralized data repository, RPA helps provide the efficiency, speed and accuracy that members, providers and regulators demand.
Manually intensive tasks are an unnecessary burden in an industry where efficiency and accuracy are essential. Our proprietary Sympraxis® Automated Workflow streamlines those tasks for intelligent, data-driven operations. Not only does our workflow make data capture and classification more efficient, it eliminates manual and redundant effort of sharing information between systems.
Healthcare payers’ mailroom and document processes are often handled separately by health plan or market or by region, each with their own workflow for claims, appeals and payments. Other times, they may be centralized to handle multiple business units. Our workflow management capabilities become especially valuable for managing multiple business unit mailroom and document management processes, and tailoring workflows according to the payer’s specific requirements.
Firstsource also offers printing and mailing business services to help you close the loop on your claims, appeals and payment cycles as well as member and provider support. Our printing and mailing operations can handle large-scale printing of letters and booklets, address validation through the U.S. Postal Service database to ensure proper delivery, folding, processing and metering. Our printing and mailing solutions also integrate with UPS Business Services to track and monitor shipment.