Mailroom Management

Efficient mailroom operations should be well suited to take in a number of different form types and formats. Documents must be processed as quickly and accurately as possible. Mishandled mail wastes valuable processing time and creates additional rework from other departments. Well run mailroom operations gain efficiencies with growth by leveraging automation and economies of scale.
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Affiliations and Partnerships

The Smart Data Solutions Mailroom is a trusted partner for over 400 healthcare payer clients.

Mailroom Management

Claim Intake

Smart Data Solutions supports a wide array of claim intake options providing solutions for small TPAs and large health plans alike. While some clients may only process standard professional, institutional, and dental claims, others receive a more varied assortment of forms including non-standard or proprietary form types. Our solution provides a complete intake process supporting all of the standard claim form types as well as non-standard collateral such as superbills, EOB attachments, repricing sheets, vision claims, and pharmacy receipts. All of these submissions are captured and converted into a normalized data stream following each payer’s unique business rules and requirements.

Mailroom Management

Correspondence Processing

Correspondence handling presents unique challenges requiring unique solutions. Forms and other inbound correspondence can be complex often requiring complicated sorting, classification, or routing. Additionally, state and regulatory requirements also impose strict turnaround times for certain markets or form types creating additional operational challenges. Smart Data Solutions has developed a robust correspondence handling workflow leveraging AI and machine learning processes to sort, categorize, index, and route your correspondence quickly and accurately setting up the rest of your downstream processes and departments for success.

Mailroom Management

Check Handling

Smart Data Solutions supports multiple check handling options depending on how you want them.

Workflow options include any of the following:

  • SDS can forward checks to your receivables department.
  • SDS can scan the checks and deliver images to you or post the images within a hosted workflow queue in our web portal.
  • SDS can deposit the checks directly into your bank accounts.

Mailroom Management

Outbound Rejection Letters

In addition to inbound mail processing, our mailroom offers outbound mail services such as returning rejection letters to providers for any erroneous or non-processable claims. These letters are printed on your letterhead and look as though they came directly from your offices. They contain an easy to understand rejection reason in plain language such as “Tax ID missing or improperly formatted” instead of complicated error codes for providers to translate. In addition to the error message, each rejection letters also contains the correction and resubmission instructions allowing providers to easily recognize and correct the issues without reaching out for additional support from your service reps.

Mailroom Management

Image Archiving

Smart Data Solutions offers a proprietary archiving tool, SafeClaim, where materials are stored for 10 years. The data is hosted out of our 2 tier IV co-location facilities with 24×7 security, dedicated power supply, and backup generators on-site. With Smart Data Solutions’ image archive and retrieval system, claim images are available for retrieval within fifteen minutes of scanning the batch. After the capture phase, the claims can be retrieved based on any data captured off the claim and retrieval screens are typically customized for each client. SafeClaim stores all claim related materials such as:

  • Paper claim image
  • Non-claim correspondence and indexed information
  • Data captured
  • EDI

Mailroom Management

Claim Intake

Smart Data Solutions supports a wide array of claim intake options providing solutions for small TPAs and large health plans alike. While some clients may only process standard professional, institutional, and dental claims, others receive a more varied assortment of forms including non-standard or proprietary form types. Our solution provides a complete intake process supporting all of the standard claim form types as well as non-standard collateral such as superbills, EOB attachments, repricing sheets, vision claims, and pharmacy receipts. All of these submissions are captured and converted into a normalized data stream following each payer’s unique business rules and requirements.

Mailroom Management

Correspondence Processing

Correspondence handling presents unique challenges requiring unique solutions. Forms and other inbound correspondence can be complex often requiring complicated sorting, classification, or routing. Additionally, state and regulatory requirements also impose strict turnaround times for certain markets or form types creating additional operational challenges. Smart Data Solutions has developed a robust correspondence handling workflow leveraging AI and machine learning processes to sort, categorize, index, and route your correspondence quickly and accurately setting up the rest of your downstream processes and departments for success.

Mailroom Management

Check Handling

Smart Data Solutions supports multiple check handling options depending on how you want them.

Workflow options include any of the following:

  • SDS can forward checks to your receivables department.
  • SDS can scan the checks and deliver images to you or post the images within a hosted workflow queue in our web portal.
  • SDS can deposit the checks directly into your bank accounts.

Mailroom Management

Outbound Rejection Letters

In addition to inbound mail processing, our mailroom offers outbound mail services such as returning rejection letters to providers for any erroneous or non-processable claims. These letters are printed on your letterhead and look as though they came directly from your offices. They contain an easy to understand rejection reason in plain language such as “Tax ID missing or improperly formatted” instead of complicated error codes for providers to translate. In addition to the error message, each rejection letters also contains the correction and resubmission instructions allowing providers to easily recognize and correct the issues without reaching out for additional support from your service reps.

Mailroom Management

Image Archiving

Smart Data Solutions offers a proprietary archiving tool, SafeClaim, where materials are stored for 10 years. The data is hosted out of our 2 tier IV co-location facilities with 24×7 security, dedicated power supply, and backup generators on-site. With Smart Data Solutions’ image archive and retrieval system, claim images are available for retrieval within fifteen minutes of scanning the batch. After the capture phase, the claims can be retrieved based on any data captured off the claim and retrieval screens are typically customized for each client. SafeClaim stores all claim related materials such as:

  • Paper claim image
  • Non-claim correspondence and indexed information
  • Data captured
  • EDI

Why Outsource?

Benefits of Outsourcing:

There are many advantages which can be gained by outsourcing your mailroom operations.

  • Mailroom operations benefit from scale allowing larger operations to function more efficiently than an in-house solution.
  • The physical footprint of your existing mailroom takes up space which could be re-purposed for other departments or functions.
  • Existing processes may be difficult to manage with little oversight or transparency into the processes.
  • Growth potential of in-house solutions requires new equipment, additional personnel, and possibly an expansion of the mailroom space.

Outsourcing eliminates these obstacles and allows you to focus on other areas such as new products or expansions into new areas.

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7 TONS
of mail per week
135,000
images per day
1100
different mail sorts
350
PO Boxes managed

Frequently Asked Questions

What do Smart Data Solutions' mailroom services include?

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We provide full mailroom capabilities and we offer the option for opening mailroom facilities in any location per customer request. Mailroom services include the following:

  • Mail Receipt
  • Mail Sort (currently our most complex client has over 170 claim sorts)
  • Automated Data Base Sorts
  • Document Preparation
  • Scanning (SDS ScanRite Scanner Control Software)
  • Automated Document Control Number (DCN) Assignment
  • Imprinting
  • Bates Stamping
  • Integrated Quality Control
  • Backlit X-Ray Scanning
  • Reject Processing
  • Reject Categorization and Associated Work Queues
  • Routing of Misdirected “White-Mail”
  • Eligibility and Claim Form Return
  • Automated Cover Letter Generation Noting All Reject Reasons
  • Automated Sort and Aggregation by Mailing Address
  • HIPAA Compliant Document Destruction

In addition, our system is complemented by our Mailroom Accountability and Control System (MACS), our internally developed mailroom control system. MACS ensures the efficient and timely delivery of mailroom services.

Our mailroom can also process “white-mail” (other documents received at the PO Box, such as doctors notes, collateral and correspondence). White-mail can be sorted by Smart Data staff prior to return or scan. Clients often categorize how they would like white-mail sorted and scanned. In addition, clients typically set-up work queues so client personnel can enter the system and process the white-mail accordingly. Mailroom employees do not leave for the day until production is complete.

What are the options for getting my claim documents to SDS’s mailroom?

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  • The payer can auto-forward their current PO Box and the claims will automatically route to SDS’ mailroom
  • SDS can open a new PO Box for the payer and then payer would publish that PO Box on their member ID cards
  • Payer can receive the claims at their current mailroom, then box them up and FedEx them to the SDS mailroom who will receive them next day

Can SDS’s mailroom handle non-claim correspondence like appeals, member reimbursements, requests for payment, Medicaid reclamation, flu shots, etc.?

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Yes, SDS intakes all paper documents and can index them and wrap workflow around each document. For example, we can index the needed fields off an appeal, route to an appeals workflow queue, and present that indexed info in an easy to read and respond to format. Or, SDS can simply scan non-claim documents and post them to work queues for the payer to retrieve and process.

How are documents sorted in SDS’s mailroom?

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SDS can sort claims based on client requests and customized business logic. We batch and sort claims in 3 categories and utilize attachment and document separators as needed. This allows us to know the claim images that need OCR and capture, and the attachment pages that don’t need capture, but need to be accompanied with the claim image when we archive it.

  • Single page claims without attachments
  • Single page with attachments – these batches utilize a document separator sheet. Since every document has exactly one claim page, we do not need the Attachment Separator. We know the first page for a document is a claim and every page after that are attachments. We do not know how many pages are on a document (since each document can have any number of attachments). Therefore, we need a Document Separator to indicate when one document stops and one starts.
  • Multi-page claims with or without attachments – These are batches where every document can have one or more of claim pages and any number of attachments. Since we do not know how many claim pages a document has we need the Attachment Separator (if there are attachments for the document). We know the first image of a document and every following image until the Attachment Separator is a claim page. If there is an Attachment Separator, every page after the Attachment Separator until the next Document Separator is an attachment page. If there are no attachments on the claim we do not need an Attachment Separator.

Does SDS scanning include automated document control number (DCN) assignment?

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Yes, SDS scanning includes automated Document Control Number (DCN) assignment, however, this is customizable. Typically we imbed the Julian date into the DCN. Regardless, our ScanRite scanning software tracks the scan and receive date of the document. This information is then indexed to the document.

How long does SDS hold originals for and how are they destroyed?

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SDS will hold the original claims for 30 days and then an on-site HIPAA compliant document destruction service shreds the claims. A SDS employee monitors at all times to ensure HIPAA compliance. We store claims by client, and each batch has a unique batch number and each document has a unique DCN number applied, so if we need to reference a physical document, we can easily find it.

How are dental film x-rays handled? What about paper x-ray images?

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SDS utilizes a backlit x-ray scanner to scan film x-rays, and then once scanned, hitches the x-ray image to the corresponding claim image so it’s easily readable. Paper x-rays are scanned via a scanner setting grayscale, or higher resolution, to ensure fidelity of the image. These x-rays are also in corresponding order following the claim image.

Does SDS perform fax processing?

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SDS has a workflow based fax processing system. Specifically, our system eliminates the need to print and scan fax receipts. We will automatically sweep your fax servers to retrieve the documents, group the pages, identify the document, data capture, edit the data, and route to the appropriate queue in correct format. We can provide reject queue notifications, and correction interfaces for your faxed documents. This, in-turn, reduces your costs and your TAT.

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CLIENT TESTIMONY

Debbie Ziegler

“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs ...”
View Story
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CLIENT TESTIMONY

Brian Janssen

“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development ...”
View Story
icon

CLIENT TESTIMONY

Matthew Estes

“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us ...”
View Story

CLIENT TESTIMONY

Debbie Ziegler

Executive Director of Operations
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
View Solution

CLIENT TESTIMONY

Brian Janssen

VP, System Solutions
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
View Solution

CLIENT TESTIMONY

Matthew Estes

Chief Information Officer
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
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Why handle the heavy lifting of your claims workflow when a smart team enhanced by AI can?

Our tools, solutions, and continued research into new AI and machine learning processes help payers nationwide reduce costs, achieve greater process efficiency, and reduce turnaround times.

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