EOB to ERA Conversion automation

Introduction about EOB to ERA Conversion Automation

Tracking and reconciling payments is one of the bigger burdens faced by all healthcare organizations. Matter of fact that there are many payers who still follow manual paper reimbursement methods like paper checks and correspondences. Few healthcare organizations do tend to avoid enrolling with EDI because they face too many underpayment and payment recoupment and keep the process manual. However managing these payment information manually will decrease the rate of reimbursement because they might delay in cashing checks or sending requested additional information to payers. Automating this process and converting paper documents to ERa format is the best way to maintain complete accountability of all payments and adjustments for future audits if any. 

Eliminating manual payment posting by paper EOB,  CAQH has estimated that $4.7 is saved per claim when using payment automation. Cost reduction is up to 50-75%. Paper EOBs are uploaded in the automation system and our AI technology reads manual EOB and converts it into electronic 835 data which will allow payment posting simply by using auto post. AI can process millions of EOB’s regardless of payer specificity. Similar to EOB to ERA conversion, denied correspondence letters are received and the AI reads and converts the correspondence into electronic data which can be used in PMS in order to segregate the correspondence to a specific department in your organization who needs to work the denial. It uses 835 data to categorize the denial and the reporting of those denials can be sliced and diced. The report will then provide information on how the revenue recovered or lost. Reports can be exported to excel format or can be downloaded in PDF format as a graph or a pie chart.

Payment reconciliation in this automation system provides reading of multiple payment data such as ACH, ERA, EOB, VCP and Non check statements and then identifies unbalanced payments, reduced receivables, revenue leakage and bad debts. This information can be exported through excel or PDF graph format 

• • EOB to 835 Conversion
  • Virtually eliminate posting errors
  • According to CAQH, savings are estimated at $4.74 per claim moving from paper to electronic!  Access EOB Conversion delivers most of this immediately!
  • Reduce costs by 50%+ or as much as 75%!

• • State of the art optical recognition technology
  • In house development
  • Best of breed multiple OCR engines
  • State of the art Machine learning
  • Semi-structured form classification
  • AWS services (SQS, S3, etc…)
  • Elastic search (history-based validations)

Step 1:

EOB received from Insurance Payer and sent to application.

Step 2:

Optical recognition technology ingests images, converts them into EDI 835 format.

Step 3:

Encrypted File delivered to partner or provider via FTPS.

Step 4:

835 auto-posts into HIS/PMS.

BillingParadise uses RPA to converting paper to electronic invoices which decrease the burden of segregation and paper EOBs are converted as respective electronic documents for easy accessing. ERA and EOB difference in medical billing, has offered the insight of how beneficial is ERA above EOB in terms of administrative management. In addition to automation, we also support practices with prior authorization services, helping reduce delays and improve reimbursement efficiency. We have already provided custom made payment document conversion to large dental groups and surgical centers and are hoping for more challenging EOB conversion methods as well. Talk to our RPA experts to learn more.