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Upload Document for OCR Scanning
Supported: PDF, JPG, PNG, TIFF — Max 25MB • CMS 1500, UB-04, ADA forms
SCANNING RESULT — CMS-1500-2025031401.pdf
Original Document
✓ High Quality Scan
CMS-1500-2025031401.pdf — Page 1 of 1
HEALTH INSURANCE CLAIM FORM — CMS-1500 (02-12)
1a. INSURED ID: MBR-2024-7734
1. MEDICARE ○ MEDICAID ○ TRICARE ● OTHER
2. PATIENT NAME: JOHNSON, ROBERT K
3. DOB: 04/17/1962
4. INSURED NAME: SAME
5. ADDR: 4421 Maple
21. DIAGNOSIS: M54.5, M47.816, G89.29
24A-J. PROCEDURES TABLE (3 lines)
25. FED TAX ID: 47-8831122
28. TOTAL: $1,250.00
33. BILLING: Dr. Sarah Chen NPI 1234567890
Extracted Fields
● 90%+ High ● 70-89% Med ● <70% Low
Document Type
Form Type
98%
Patient Info
Patient Name
97%
Member ID
99%
Date of Birth
78%
Address
54%
Clinical
Diagnosis
95%
Service Date
96%
Total Charge
82%
Provider NPI
99%
AI Assistant

OCR Processing uses AI to extract structured data from scanned paper claims. The side-by-side view lets you review and correct extracted fields before mapping to a claim record.

  • Green (90%+): High confidence — likely correct, minimal review needed
  • Amber (70-89%): Medium confidence — review recommended
  • Red (<70%): Low confidence — manual correction required before mapping
  • CMS-1500 — Professional claims
  • UB-04 — Institutional claims
  • ADA Dental Form J400
  • Remittance / EOB documents
  • Authorization letters
  1. Upload scanned document
  2. AI extracts fields automatically
  3. Review highlighted fields in document view
  4. Correct any low/medium confidence fields
  5. Click "Confirm & Map" to create claim