Converting EOBs to 835 Electronic Remittance Advices
Optical Character Recognition (OCR) in its simplest form is the process whereby a paper document is scanned and the image is captured for processing data into a specific application, such as paper-based EOBs. The text is extracted from an image and converted into machine readable data (as 835 electronic remittance advices) . The problem with OCR processing for paper EOBs, more specifically, 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.
With standardized data elements, where the fields and locations are all consistent, additional programming features can be added to OCR technology to streamline the processing and validation of information.
Once mapping and processing rules have been established for a specific payer, ReMedics Advanced OCR System will check 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. Information from other systems and data sources can also be utilized to look for and correct information. When all of the data is captured and corrected, including all other batch files, the data will be added to our Payment Processing and Treasury BPO Services.
Correspondence Document Management
In addition to converting EOBs to electronic files, ReMedics can also provide for the indexing of your lockbox correspondence, such as: Claims; Pre-Certifications; Denial Information; Appeal Letters; Independent Reviews; Forms; and Legal Requests. By providing staff with a complete record that is indexed, searchable and integrated to your PM or EMR system, the billing department is no longer dealing with searching through files for paper documents or in disconnected, disparate systems. The result is greater efficiency throughout the revenue cycle and less re-work in denials.
With a significant number of payers (or payors) still not sending electronic 835 files, ReMedics can help you to convert paper EOBs for payment processing and index your lockbox correspondence document images. Contact ReMedics online or call 440-671-7700 to talk about how our Advanced OCR Technology can work for your organization.
*Editor’s Note: Portions of this article were previously published by our technology partner, RCMS LLC, and used with permission.