echopay - Intelligent EOB processing solution
Healthcare remittances are delivered via Explanation of Benefit (EOBs) documents to transact payments between healthcare providers and payers. Unfortunately, the EOBs vary significantly among payers. The lack of standardization of image format, image quality, and the varying number of line items in each patient-physician encounter makes it a highly manual process to interpret and process large volumes of EOBs.
As a leading provider of healthcare revenue cycle services, Access Healthcare processes over 100 M payment transactions per annum, which is, perhaps, the largest volume of payment transactions processed on a single platform.
Access Healthcare developed and deployed echopay, an intelligent, automated payment posting solution. The solution eliminated almost all the manual tasks and errors associated with EoB processing. Echopay applies multiple technologies – optical character recognition, machine learning.
The echopay platform addresses varying file formats across over 3,000 payers, differences in the number of line items in each Explanation of Benefits (EOB), and 1,000s of payer and provider-specific business rules, the task of processing over 100 M transactions p.a. can be very daunting.
echopay Features
Data Capture
Automated sorting and batching of EOBs, application of multiple OCR engines, and comparison of captured data to ensure higher posting accuracy
Recognizes over 3,000 payers and payer-specific EOB formats
Addresses quality issues such as greyscale images, blurred images, etc.
Rules-based identification of exceptions to allow manual intervention for processing exceptions
Robust Business rules Engine
Practitioner developed, pre-configured business rules for thousands of payers
Ability to recognize exception patterns, identify opportunities to add new rules, and reduce exception processing
Over 900 business rules to be used to classify, enrich, apply reconciliation logic, and post the captured data as per payer/provider guidelines
Format Recognition
Application of machine learning tools to improve payer format recognition and reduce manual exception processing
Utilizes machine learning to the onboarding of new payers with limited configuration efforts
API based integration to core systems
Output format compatible with the ANSI EDI standards, i.e., 835 and 837
Contact us to learn more about Access Healthcare’s echopay solution.
