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Why Digital Coworkers are the best data extraction tools for UB-04 forms

Jessica France
July 18, 2022

In recent years we have seen huge strides forward with regards to artificial intelligence (AI). While many people are skeptical about AI, the reality is that it is already used in everyday activities, often behind-the-scenes. Here at Roots Automation, we have created our very own Digital Coworker which incorporates the latest in AI and process automation technology.  

One area where there is a significant amount of repetition is the medical insurance industry. Consequently, Digital Coworkers are now becoming commonplace and an integral part of data extraction. We will now take a look at why Digital Coworkers are the best data extraction tools for UB-04 Forms.

What is a UB-04 Form?

Before we delve deeper into the world of automated AI services, let us have a closer look at a UB-04 Form. The original form was developed by the Centers for Medicare and Medicaid and is now an industry standard used by institutional providers to process medical and mental health insurance claims. While the American Hospital Association owns the copyright of the official UB-04 Form, it is widely used by many institutions.

What is a UB-04 Form used for?

Similar to a CMS-1500 Form (used by non-institutional providers and suppliers), the UB-04 Form is a useful means of gathering all of the data required to process insurance claims. This form is used by a range of institutions including:

  • Community mental health centers
  • Home health agencies
  • Hospitals
  • Hospices
  • Rural health clinics
  • Skilled nursing facilities

While individual medical insurance companies may require slightly different information, the UB-04 Form ensures that all of the relevant information is gathered in one place. Next challenge, processing these forms in an efficient and accurate manner!

See also: How the CMS-1500 Form Became the Industry Standard for Medical Claims

What are data extraction tools?

Historically, many medical insurance companies used data entry outsourcing companies to process their medical claims. While there is no doubt this assisted profit margins, speed and costs at the time, the development of AI fuelled automated bots, otherwise known as Digital Coworkers, has taken this to a whole new level.

Digital Coworkers, often referred to as Cognitive Process Automation (CPA), or the latest generation of Robotic Process Automation (RPA), are now the new measure of speed, accuracy and AI learning when it comes to processing medical claims.

This then prompts the question, why are Digital Coworkers the most appropriate data extraction tool for UB-04 Forms?

Are UB-04 Forms and Digital Coworkers a match made in heaven?

Collating data relating to medical insurance claims is relatively straightforward when using a UB-04 Claim Form. This is a catchall form which gathers an array of information which will be relevant to different insurers. One of the main problems relates to the way in which the form is completed, which can create processing challenges such as:

  • Data entry outside of relevant fields/boxes
  • Different handwriting styles
  • Manual data input error rate
  • Manual data input speed rate
  • Cost of data entry

Medical insurance BPO was initially seen by many as the answer to some of the accuracy, speed and cost challenges. This process has now been superseded by AI bots which can be “trained” to carry out any automated process, hence the name Digital Coworker.

The many benefits of Digital Coworkers

Data extraction software of years gone by was helpful but unless the information was in a specific area, and written clearly, there could be serious issues with regards to accuracy. The information needed to be spoon-fed at which point it would be automatically processed. The main benefits that Digital Coworkers have over their earlier counterparts include:

Optical character recognition (OCR)

The latest in OCR is able to distinguish between different types of handwriting and does not require information to be in a specific box or area. In effect, we are now working with AI which has the foresight to go looking for information as opposed to being spoon-fed.

Building a trained employee

Here at Roots Automation, we have a library of parts which address multiple facets of business processes. Akin to a jigsaw, we are able to bring together these various parts to create a Digital Coworker that instantly steps into the role of data extraction and data processing. In reality, we are building an employee with the exact skills and credentials for the role – the perfect employment candidate!

Plug-and-play solution

When looking at our competitors, not only do we offer much better value for money but we offer the ultimate plug-and-play solution. What does this mean?

Rather than selling you the pieces of the jigsaw to build your own Digital Coworker, with considerable IT costs and time, it already comes pre-built and trained. In just 4 to 6 weeks, we can fully train your new AI-fuelled bot to carry out a range of automated tasks. The simple plug-and-play solution means there are no IT expenses and no complicated implementation process. Once we deliver your robotic bot, it is ready to go.

Secure

When it comes to security there are many challenges for online companies that have joined the digital revolution. We are often asked about security and how one or more Digital Coworkers might impact your network. Our system is fully cloud-based, using Microsoft Azure, offering the latest in security firewalls. Rest assured we take security extremely seriously.

Continuous learning

Many of our customers are astounded by the immediate cost benefits. The average breakeven period is around five months with a 250% return on investment. This is before even considering the long-term AI benefits of ever improving efficiency and accuracy. Our bots are akin to an ambitious worker, looking to learn, develop, and improve, chasing that promotion!

 

Speed

While accuracy comes before speed, there are a few AI data extraction tools which can deliver a speed pickup of between 400% and 800% compared to a human worker. Our extraction tools are hungry for data and keen to become even more efficient.  

Accuracy

If there is the slightest suspicion of inaccurate data, this can lead to significant expenditure on data checks and new data validation. We know from real-time experience that our Digital Coworkers have a 99% straight-through processing rate, which is higher than that of humans.

See also: Medical Claims Clearing House vs Automated Medical Claims Processing

Automation in insurance industry

Insurance automation systems are fast replacing healthcare BPO and the use of data entry outsourcing companies. Where a process can be automated, the procedure can be significantly enhanced with the introduction of AI. Cognitive solutions are now available working side-by-side with humans, performing a wide range of tasks within set criteria. The opportunity to leverage machine learning, training and improving a Digital Coworker is one that deserves serious consideration.

Is this the Holy Grail of data extraction?

The transfer of data from capture forms such as the UB-04 Claim Form has created significant challenges for many medical insurance companies. Our Digital Coworkers are highly focused, customised programmed bots which can carry out an array of automated processes, while using AI to adapt and improve. As we touched on above, there are many issues to take it consideration such as cost, speed, accuracy and the ability to reallocate resources to front end services and business initiatives. The introduction of AI automated services is already becoming standard amongst leading US insurance companies.  

Are you maximizing your resources? Are you leveraging the skills and services available to you?

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