Outsourced Payment Processing for Healthcare Remittance

Streamlined Payment Processing – for Physician Practice Groups, MSOs, Hospitals and Health Systems

ReMedics streamlines the payment processing of all paper and electronic remittance, enhanced by AI and Robotics Processing Automation (RPA) technology — integrated to your EMR/Practice Management System(s) and Clearinghouses.

In systems that support electronic uploading of remittance data, our proprietary payment processing software automatically checks the data for accuracy, system errors and missing information that can delay payment. In most cases, we can identify the information required to quickly validate a claim by viewing the EOB and/or correspondence captured and indexed in our system.

Payment Posting and Reconciliation

We work with your banking institutions through both retail and wholesale lockbox(es) for payment consolidation and document capture of paper remittances. Once processed, ReMedics provides normalized 835 files for direct integration to your Practice Management System(s) in a multi-submitter, single receiver environment. Reconciliation of all lockbox/remittances is completed through ReMedics Treasury Reconciliation solution whereby your bank deposits are segmented by division or business unit.

Data Validation Rules & Integrity

ReMedics ensures that correct information is applied to patient accounting systems by cleansing data prior to upload. A configurable rules-based engine scrubs ANSI 835 payment data before it’s submitted to the Line of Business (LOB) system. We also provide automated work queues for exceptions to be worked in an on-line tool for correction and re-submission. Our solutions apply over 200 business validation rules prior to upload, giving us the ability to check for missing or incorrect information. Regardless of how the original data was captured, data integrity is improved resulting in fewer items to be worked as downstream exceptions.

835 EDI Remittance Parsing/Splitting Services

Co-mingled remittance transactions can be automatically split using client-defined criteria and associated with the appropriate Business Unit’s Practice Management System. Bank deposits are segmented by Business Unit, balanced and reconciled daily for divisional and corporate-wide groups. Our prescheduled daily reports will confirm that all funds have been distributed to their respective business units. 

Paper to 835 Conversion

For systems that don’t support electronic upload or lack EDI automation, ReMedics fully outsourced payment processing services provide comprehensive paper to 835 conversions, as well as conversion to HIPAA-standard remark codes for payers. We utilize OCR and Key from Image (KFI) workflow, along with Artificial Intelligence (AI) to efficiently process your paper EOBs, downloaded to our secure, web-based portal and document management system. 

ReMedics Payment Processing Benefits

  • Business Process Outsourcing (BPO) solution for fully outsourced payment processing solution
  • Seamlessly integrated with existing EMRs and Practice Management (PM) Systems 
  • Supports multi-submitter, single receiver practice aggregation business model
  • Integrated processes and centralized location for all payments, denials and reimbursements
  • EDI and paper-based claim capture with rules-based validation to identify missing data
  • Receive ERA files for all payors/providers, including those that only provide paper
  • Normalize 835 & 837 data across payors and providers
  • Ability to support system specific data requirements
  • Capture of all denial codes, zero pays, comments and other transactions
  • Automated transaction validation, payment posting and data repair
  • Staff is only handling exception errors when necessary
  • Reduced staffing costs and timely secondary billing
  • Bank deposits segmented by division, balanced, and reconciled daily at divisional and enterprise level
  • Maintain practice group/business unit autonomy

Learn more about ReMedics RCO services.