Processing Medical Claims

Digitizing the medical files archive

The national union of socialist mutual benefits societies installed an IRIS solution to optimize their document processing. With this solution based on the IRISPowerscan™ and IRISNext™ technology they have digitized the files of their 3.1 million affiliates, and are now also automatically processing medical claims (treatment certificates).

What they were looking for, was a digital archiving solution that could also manage electronic documents. This is exactly what the IRIS solution provides with the OCR scanning software IRISPowerscan™ and the workflow software IRISNext™.

Benefits of this scan, OCR and workflow solution

In a first phase, all medical records were scanned, given an OCR layer and saved in IRISNext™. In a second phase, the solution was also implemented for the automatic processing of medical claims in order to modernize the compensation department.

This also had a positive effect on the customer service department. The quality of the answers given via telephone greatly improved now there was no longer a need to look for the information in paper documents. By simply asking the client’s registration number or national number, the correct file with the latest information is pulled up.

Another advantage for the organization was the capability to have digital workflows. Electronic documents and files can now easily be transferred from one federation to another and can be consulted from anywhere within the territory. In the past that was not possible, either the files had to be physically transported or copies had to be made. Now, with an internet connection, all electronic documents can be accessed anytime, anywhere.

IRISPowerscan™ enables us to have digital workflows, which saves time and facilitates information sharing across our organization
Christophe Godart, ICT Director, Solidaris

Our aim was to try to have a paper equivalent of the member’s file and we did not want a file without a central theme or chronology. So our grand plan was to work on indexing and enriching all of these documents. The main advantage is the accessibility of data. It can be accessed anywhere and at any time. The other advantage is the ease of searching now. In the past, it was possible to misplace documents in other people’s files. But now, thanks to the powerful indexing of these documents, using a simple search, we always find our documents.
Christophe Godart, ICT Director, Solidaris

Solution with:

Key facts

  • Handling data from 3.1 million clients
  • Improving customer care
  • Creating digital workflows
  • High-Quality OCR