Insurance Medical Claims

Medical Claims

Reducing documents tampering and improving automation

Medical claims processing continues to remain paper intensive especially in the case of out of network providers. It is also subject to duplication of entries due to different systems being used by service providers and the TPAs/insurance companies. To reduce the possibility of tampering with the claim documents and to ensure quicker processing of information, it would be ideal to find a way in which the information can be trusted and easily ingested for processing.

By using Qryptal, the data on the patient’s invoice or receipt can be captured in the form of a QR code before it gets printed either physically or electronically. This can be then validated by the TPA and/or insurance company using the validator software and it can be further absorbed for processing after one-time integration. This would make the entire claim process experience very smooth for the customer while maintaining the privacy and integrity of the data.

An example of a hospital bill or invoice carrying the Qryptal QR code is given here

Comparison of traditional vs Qryptal enabled claims processing

This has several advantages as explained earlier

• Quicker processing
• All fraudulent or tampered claims can be identified
• Very good for security and privacy
• Works for both electronic and printed claim documents
• Each QR code is unique and digitally signed by the issuing clinic or hospital with its private key and once processed, it can be cross checked for to avoid duplication and a double processing of claims
• Information from the QR code can be easily ingested into the processing system of the insurer without manual intervention after one-time integration which can help save cost, time and avoid errors