Converting Paper EOBs to 835 Normalized Data

Utilizing Advanced OCR Technology for Converting Paper-Based EOBs

One of the many technologies used by ReMedics to automate payment processing for our healthcare clients is Optical Character Recognition. Utilizing OCR technology, text is extracted from an image, such as paper-based EOBs, and converted into machine readable data. The problem with processing paper EOBs is they come from different health insurance payers utilizing their own unique document templates. Therefore, not all of the data is in the same ‘mapped’ locations across all payers. 

By adding programming features to standardize the data elements for each payer, ReMedics OCR data capture can then be automated to streamline the processing and validation of information.

Once mapping and processing rules have been established for each specific payer, our system checks for certain types of characters (or number of characters) in specific alpha-numeric sequences — before human intervention is required. Any extracted data that doesn’t meet certain criteria is then flagged for review and edits — with staff having access to the original scanned image. Interfaces to other HIS applications can also be utilized to look for and correct patient information.

Claim Validation and Lowering Initial Denial Rate

Utilizing our proprietary interfaces and workflow technologies, we upload all of the data received into our payment validation editor. This includes all paper and EDI documentation. ReMedics experienced staff then examines each claim in a batch file to make sure that it’s either validated or added to actionable exception worklists. The EOBs and Correspondence can be accessed in Document Management system for retrieval. The worklists allow for our staff and/or clients to quickly resolve issues with missing or incorrect information. This process also identifies claims that would typically be denied; lowering initial denial rates.

Remittance Processing, Validation and Bank Reconciliation Services

ReMedics offers a unique combination of outsourced services, systems integration and workflow automation capabilities. This enables us to provide a full spectrum of Business Process Outsourcing Services for just about any size healthcare delivery organization. Let us know what your needs are. Contact us online — or call 440-671-7700.

Editor’s note: parts of this article were extracted with permission from our technology partner RCMS, LLC.