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SUCCESS STORY |
AUTOMATED EOB PROCESSING |
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Client |
Large cardiology practice in Northern Ohio, USA |
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Project |
Automating EOB Processing |
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Systems Integrator |
IKON |
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Products |
PROSAR-AIDA, PROKEY |
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Publications |
Automated EOB Processing Success Story (PDF)
Whitepaper: PROSAR-AIDA and EOB Processing (PDF)
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| Company Background |
A large cardiology practice in Northern Ohio was looking for a way to reduce data entry costs associated with Explanation of Benefits (EOB) processing. In the past they had entered medical procedures and the associated payment information into an IDX(TM) system via a "key from paper" approach. The system reconciled the check received from an insurance company with the many procedures for many patients that made up this payment. In early 2004, they were tasked with improving the overall process by deploying a cost effective solution that would meet financial and operational ROI objectives.
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Challenge |
- Extract data from potentially many hundreds of different EOB layouts
- Find a solution with a proven track record
- Eliminate the need for paper retention
- Automate data extraction of EOB data
- Increase the amount of data captured to include data needed to recover revenue (e.g. zero amounts paid procedures, paid amounts not matching contract, inappropriate denial codes)
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Solution |
Scan is performed by Ascent Capture. Data extraction and validation are performed by PROSAR-AIDA and PROKEY respectively. PROSAR-AIDA and PROKEY are certified custom modules for Ascent Capture and plug in conveniently in the Ascent Capture queue. PROSAR-AIDA is used for automatic extraction of data while PROKEY is used to allow an operator to validate uncertain data.
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Results |
- Data automation rates in excess of 75% across all insurance company layouts
- Eliminated the majority of manual data entry work
- Seamless interface into Westbrook Fortis™ imaging system
- Provision of data needed in order to generate exception reports (e.g. procedures where "paid" amount is zero ....)
- Increased accuracy of data
- More data can be provided for customer service databases than could have been possible via manual data entry
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Healthcare
