Payment Management Services

Payment Posting Automation

From Paper EOB to 835 conversions, modifying ERAs to bank reconciliation, this service will optimize your remittance and payment processing functions.

Paper EOB Capture & Conversion:

  • We convert paper EOBs into electronic postable 835 EDI files replacing the need for manual payment posting. By eliminating manual capture of EOB information, we reduce the frequency of data entry errors seen when posting EOBs.
  • We match the data captured from the paper EOBs to the original 837 claim data, supplement the missing data and create a postable 835. We guarantee 99%+ posting accuracy for newly created 835 files with our ability to convert paper EOBs from every possible payer.
  • We also have a process to map the proprietary payer denial codes to the standard ANSI denial codes, increasing the ability of your denial management to address denials on paper EOBs.
  • With a maximum turnaround time of 24 hours, we guarantee no delays in payment posting.

Modify payer ERAs:

  • About 5% of ERAs from payers kick out due to missing data.
  • We reformat these payer sent ERA (835) files, this preventing the need for manual posting. These reformatted files can now post automatically.

Patient Payment Processing

  • We can convert paper patient payments into custom electronic files. This leads to seamless posting of patient payments along with commercial payments. This ensures there are no delays in the processing of payments.

Indexing of Payer Correspondence

  • We identify and classify all types of payer correspondence documents. We extract crucial index data from the segregated documents. These indexed documents can be imported into a DMS, making the searching and routing of the documents much more efficient. This ensures timely responses to payer additional information requests and streamlining filing of appeals/denials, leading to reduced financial losses.

Bank Reconciliation

  • Our automated system helps match remittance advices (ERA and paper EOBs) to the right payment reference in your bank account. This leads to the easy availability of reports of missing payments or missing remittance advice. It helps to track remittance transactions and identify whether the ‘payment received but EOB missing’ or ‘EOB received but no payment received’. It enables the provider’s PM system to always reflect real-time account balances.

Denial Management Solution

  • Our automated system helps analyze denials to help determine the root cause. It ensures continuous and constant attention to track unexpected denials and assists in pointing out new problems that might crop up and affect the process. It also helps build customizable logic to auto-route denials to specific users. It additionally helps to create interactive charts and select your top denials for appeals.

Document Management System

  • It enables instant access to all payer correspondence and paper EOBs and provides an efficient search interface.