Handles 98% of Billing Forms

The Challenge

During a general presentation for Lexmata functions and features, a senior paralegal from one of the nations largest plaintiff law firms recognized that Lexmata could identify medical billing codes. After the presentation she reached out to our development team to see if we could identify each code, then extract the relevant information from the billing codes, export them that to an Excel spreadsheet and then total up the columns to see all the gross buildings and payments.

The paralegals responsibilities included managing Personal Injury Protection (PIP) insurance coverage. This is a process to identify where carriers have failed to meet a clients coverage for personal injury. She manages a group of 15 to 20 reviewers that had been manually reviewing tens of thousands of injury claims. Their process generally took anywhere between 15 and 30 minutes per file to accumulate and compare the relevant information. She asked if Lexmata would be able to automate that process.

Result

After several days of customized development, Lexmata was programmed to automate 90% of their functions. This reduces the amount of time to accumulate and compare against Medicare and Medicaid cost structures to determine any variation in claim as opposed to payment. Initially Lexmata was able to handle about 85% of the different variations in forms. By continuing to adjust and tune for new form formats we have now taken that up to approximately 98%.

We are now saving the client hundreds of manual hours and thousands of dollars in monthly cost. The client can’t imagine going back to their old process.