Selasa, 27 Mei 2014

This article will discuss capture software for Explanation of Benefits. Hospitals and group medical practices - commonly called Providers - face a significant capture challenge every day: processing the remittance paperwork that accompanies payment from health insurance carriers, a document known as an Explanation of Benefits (EOB).




The challenge Providers face is the accurate processing of each EOB - they must determine whether full payment has been received and the claim can be closed or if it has not and must be resubmitted. Since EOB data is used to update the remittance processing system and patient medical records, there is often significant data entry involved.





Capture Software for EOBs



Capture software for EOBs can streamline and automate EOB review and data entry, enabling you to quickly credit payments and identify claims that have not been fully paid. Capture software for EOBs can help your organization:





- Increase data entry efficiency and accuracy



- Ensure complete Remittance Advice transactions are delivered to your



accounts receivable system



- Balance EOBs to check received



- Index EOB images for archival purposes



- Successfully exports data in 835 format





Capture software for EOBs uses optical character recognition (OCR) to automatically read data from scanned EOB's, then uses validations and math calculations to total the transaction line items and compare them to each subtotal, thereby ensuring balanced patient information.





Capture software for EOBs provides you with productivity tools to speed processing and assure accurate data. Relieved of manual data entry tasks, EOB processors simply view a verification panel that enables them to quickly check each claim and service line. Shortcuts and hotkeys enable them to fix low confidence characters quickly and efficiently. Lines that do not balance are highlighted in red for an operator to swiftly determine a course of action. Finally, all data is properly formatted for delivery to your remittance processing and patient records systems.





Capture software for EOBs automates the processing of EOBs for Providers, significantly increases speed and accuracy, eliminates manual data entry, and saves your company money.





Complete, Ready to Use Solution



- Support for single and multi-page variations



- Attachment support



- Predefined users, groups, stations



- User productivity reports



- Recognition runs as Windows "service"



- Job Monitor displays current batch status





Single-Pass, Modeless Verification



- One panel enables character correction, field validations and zooming on image



- Data entry by document, including all pages



- Super snippet image display



- Automatic claim field highlighting



- Designer for panel layout changes



- Go to next problem character/field/claim/EOB key



- Hotkeys for common operations



- Send EOB to supervisor





EOB Identification



- Capture software assigns new fingerprint automatically to each new EOB format



- Captures header information



- Matches to master table with address and payment details



- Capture software locates line item details



- Guarantees





Business Rule Configurability



- Non-scripting interface for rule management



- Library of 100's of standard rules



- Applies global rules to all EOBs



- Supports EOB-specific rules



- Database access via ODBC



- Math calculations on payments



- Extensible rules via Microsoft VB Script



- Runs multiple rules per field





Award-winning Taskmaster Platform



- Complete single solution for data and document capture



- Flexible, rules-based technology



- Browser-based scanning and indexing



- Easy to use and manage



- Customizable interface





Data Delivery



- Capture software delivers EOB images with indexes to ECM system



- Posts data directly to remittance system



- Formats output under Rules control



- Reports on system productivity



- Deletes batches automatically after target system acknowledgement


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