SYSTEMS AND METHODS FOR DOCUMENT MANAGEMENT
In one embodiment, a document management system is provided that automatically converts documents submitted electronically with or for a claim into a format that is required by a third-party payor. The document management system maintains a list of document format and delivery preferences for each third-party payor. Rather than submit a claim and document directly to the third-party payor, the submitter submits the claim and document to the document management system using a portal that accepts a wide variety of electronic document formats. The document management system then retrieves the format and delivery preferences of the third-party payor and converts the documents into whatever format is required by the third-party payor. The document management system then delivers the converted document to the third-party payor according to the delivery preferences such as email, fax, or regular mail.
1 . A method for managing document formats and delivery comprising:
receiving a document in a first data format of a plurality of formats by a computing device, wherein the document is associated with a matter identifier and a third-party payor;
determining document preferences associated with the third-party payor by the computing device, wherein the document preferences identify a second data format of the plurality of formats and one or more document delivery preferences;
converting the document to the second data format by the computing device; and
providing the document to the third-party in the second data format by the computing device according to the document delivery preferences.
2 . The method of claim 1 , wherein receiving the document comprises receiving the document through one or more of an application program interface or a portal application.
3 . The method of claim 1 , wherein the document is received in a batch along with a plurality of documents.
4 . The method of claim 1 , wherein the document is received in a 277 document format.
5 . The method of claim 1 , wherein the matter identifier is a claim identifier, and the document is received in support of an insurance claim for the third-party payor.
6 . The method of claim 1 , further comprising:
converting the document from the first data format to a third data format, wherein the third data format is an intermediate data format; and
storing the document in the third data format in a datastore, and wherein converting the document to the second data format comprises:
retrieving the document from the datastore; and
converting the document from the third data format to the second data format.
7 . The method of claim 1 , wherein the delivery preferences comprise one or more of a preference for mail delivery, a preference for fax delivery, a preference for electronic delivery, a preference for a batch delivery, and a preference for delivery through a portal associated with the third-party payor.
8 . The method of claim 1 , wherein the document is received from a submitter, and further comprising:
receiving a communication associated with the document from the third-party payor, wherein the communication is associated with the matter identifier;
based on the matter identifier, determining the submitter that provided the document; and
providing the communication to the submitter.
9 . The method of claim 8 , wherein the communication indicates that the document was accepted or rejected by the third-party payor.
10 . The method of claim 1 , wherein the third-party payor is a medical insurance provider.
11 . The method of claim 1 , wherein the document preferences are received from the third-party payor.
12 . A system for managing documents and document providers, the system comprising:
at least one computing device; and
a memory storing computer-executable instructions that when executed by the at least one computing device cause the at least one computing device to:
receive a document in a first data format of a plurality of formats, wherein the document is associated with a matter identifier and a third-party payor;
determine document preferences associated with the third-party payor, wherein the document preferences identify a second data format of the plurality of formats and one or more document delivery preferences;
convert the document to the second data format; and
provide the document to the third-party in the second data format according to the document delivery preferences.
13 . The system of claim 12 , wherein receiving the document comprises receiving the document through one or more of an application program interface or a portal application.
14 . The system of claim 12 , wherein the document is received in a batch along with a plurality of documents.
15 . The system of claim 12 , wherein the document is received in a 277 document format.
16 . The system of claim 12 , wherein the matter identifier is a claim identifier, and the document is received as part of an insurance claim for the third-party payor.
17 . The system of claim 12 , further comprising:
converting the document from the first data format to a third data format, wherein the third data format is an intermediate data format; and
storing the document in the third data format in a datastore, and wherein converting the document to the second data format comprises:
retrieving the document from the datastore; and
converting the document from the third data format to the second data format.
18 . The system of claim 17 , wherein the delivery preferences comprise one or more of a preference for mail delivery, a preference for fax delivery, a preference for electronic delivery, a preference for a batch delivery, and a preference for delivery through a portal associated with the third-party payor.
19 . The system of claim 12 , wherein the document is received from a submitter, and further comprising:
receiving a communication associated with the document from the third-party payor, wherein the communication is associated with the matter identifier;
based on the matter identifier, determining the submitter that provided the document; and
providing the communication to the submitter.
20 . The system of claim 19 , wherein the communication indicates that the document was accepted or rejected by the third-party payor.