OSP Labs Engineered Tailored Cloud-based Claim Review System

Nov 23, 2019


The Healthcare industry is dynamic and changing at a faster pace. The rapid changes to diagnostic and procedure codes, variable needs of medical insurance organizations, and billing errors pose more significant challenges to existing claim management systems. OSP Labs has engineered a full-scale and tailored post-payment claim review model to enhance the claim processing workflow and ensure the accuracy of the adjudicated claims using patient authorization, Pokitdot APIs, and claim scrubbing tools. 

“According to American Academy of Family Physicians (AAFP) recent report, the average claim denial rate across the healthcare industry is between 5 to 10%. Healthcare providers and patients need an automated and web-based claim review system to easily upload standard EOB forms, avoid claim errors and reduce the turnaround time,” said John Russo, VP of Technology at OSP Labs.  

OSP has built an automated web-based claim review system to simplify the claim reviewing process. Their customized solutions help perform Pokitdok X12 API Claim Status Call to export patients’ data and validate the claim using the AETNA guidelines. The system extracts ICD-10 and CPT codes from uploaded EOBs, and the in-built claim scrubbing tool automatically validates these codes against specified Aetna guidelines, CDC, and NCCI guidelines.  

OSP has exponentially reduced the turnaround time for the entire claim reviewing process to generate 100% error-free EORs.  

About OSP: 

OSP is a specialty provider of tailored healthcare software solutions to help the entire healthcare ecosystem, including providers, payers, and billing organizations. As tech experts, we strive to accelerate innovation in the healthcare domain with a client-centric approach and advanced technologies.