QAI PRESCRIBES LARGE-VOLUME SCANNING SOLUTION FOR THE OFFICE OF MEDICARE HEARINGS AND APPEALS
BACKGROUND AND CHALLENGES
The U.S. Department of Health & Human Services’ Office of Medicare Hearings and Appeals (OMHA) administers appeal hearings for the Medicare program. Created by the Medicare Modernization Act of 2003 to simplify the appeals process, the organization is responsible for “Level 3” claims appeals within the five-level structure.
Since opening its doors in 2005, OMHA has processed approximately 585,000 appeals, representing millions of pages of written hearing requests. Unprocessed appeals in backlog, which were previously stored at a National Archives and Records Administration (NARA) warehouse in Dayton, Ohio, numbered more than 9,500 boxes. On top of that, OMHA receives thousands of new hearing requests each week.
With the goal of creating a paperless office environment and complying with the Presidential Directive on Managing Government Records, OMHA sought a way to capture, manage, store and preserve these hearing request files in an electronic format. As a result, the organization would be able to easily search for, retrieve and view appeal files and the information they contain.
OMHA contracted Quality Associates, Inc. (QAI) to spearhead the project. QAI worked with its partners, IBM and ibml, to devise a secure, sophisticated, customized scanning and electronic document management solution capable of processing one million pages per month.
Consisting of scanners, analytics software and quality control procedures, the solution entailed a LEAN, Six Sigma process to ensure an effective, pull-based workflow. First, staff members conducted an inventory for each box of records, creating file names and associated barcode labels. This information was entered into an IBM-developed inventory tracking system, which tracks the boxes and files as they move through the scanning process.
Once files were prepared, each document was scanned using ibml’s ImageTrac-Lite scanner, and ibml’s SoftTrac Capture Suite (SCS) to read each barcode and intelligently name the file within the system. With the ability to scan 286 pages per minute, the ImageTrac provided the capacity to handle OMHA’s sizeable backlog.
After the documents were scanned, ibml’s SCS Quality Control module processed each image to remove imperfections and rotate documents. Next, QAI’s quality assurance (QA) team performed an image check, manually reviewing each and every image to ensure proper manipulation, accurate folder/file names, readability and more.
After the documents passed quality control, they were converted into searchable PDFs using ibml’s SCS PostScan module. The entire scanning and capture process was centrally managed by ibml’s SCS Analytics, which provided a holistic view of performance metrics across the capture operation.
The QAI-designed solution is processing 30 boxes per day, consisting of 1,800 pages per box, for a total of 54,000 images/pages daily. This throughput rate allows QAI to process approximately 270,000 images/pages per week, thereby meeting OMHA’s requirement of scanning 1 million images/pages per month. Thus far, QAI has taken possession of more than 5,600 boxes with 10 million pages.
With its large backlog of files scanned and indexed, OMHA is one step closer to a paperless office. It is also achieving the goal of more efficiently managing its records and ensuring the long-term preservation and security of all documentation.