The OCR Solution For Automated EOB Processing

OCR-based EOB automation software has been a red-hot topic as of late. On the one hand, many healthcare organizations would say their billing is already electronic. They’re making great use of the EDI 835 and 837 transaction sets and, for all intents and purposes, they’ve “gone digital” all over the place.

But digging deeper reveals a wrinkle. More often than not, only about 80% of transactions are actually digital. Obviously, that’s the vast majority, so revenue cycle teams are correct in saying that their billing process is mostly paperless. Here’s the rub, though: the remaining 20% on paper makes up much more than 20% of the processing costs, and leads to far more denials and write-offs than it should.

Thus arises the phenomenon of a revenue cycle team that looks and feels digital, yet still finds itself paralyzed by paper documents!

How OCR EOB Automation Strengthens Business

Since claims processing costs are a subset of overall labor costs, they have a direct relationship to profitability. It’s clear that disproportionately labor-intensive claims are a disproportionate financial burden on the organization.

Unfortunately, that’s not the end of the story. Not only does paper documentation (or paper checks mixed with EDI data) take longer to process, but when claims are denied, the cost of pursuing small ones is rarely even worth it! Write-offs increase as a result, which compounds the financial burden of that 20% of total claim volume.

In healthcare, it’s tough to prevent paper from entering the office in the first place, so the most pragmatic option is to minimize its impact on business and care. That impact boils down to two fundamental pain points:

  • Labor-intensive classification, routing, and matching of claims and supporting documents
  • Unacceptable time and error rates associated with manual data entry

The remedy for both is a finely tuned EOB automation solution that uses OCR technology to eliminate the pain of paper. This often yields immediate reductions in costs, write-offs, and the rate of error-related denials in the first place.

As an added benefit, digitized paper claims are more accessible to customer service teams that require ad-hoc access to documents around a billing event. Instead of hours or days of research to track down checks and forms, they can do so immediately on their desktops–even while still on the phone with a patient, for instance. And the sooner a patient’s questions are answered, the sooner he or she is able to pay.

Why ABBYY FlexiCapture OCR For EOB Processing?

The beauty of ABBYY FlexiCapture is how quickly its users can see measurable improvements to the revenue cycle. Three features in particular help make this a reality, so let’s take a quick tour of each of them.

Accurate Recognition

The fastest OCR engine in the world can only be as useful as its results are accurate. OCR software for EOB processing bears a special burden in this regard. Not only does its accuracy have financial effects, but correct recognition ultimately helps patients receive care more promptly.

Depending on the text quality and document layout (see the next point), FlexiCapture’s accuracy often approaches 99+%. At this point, the only human involvement is a few keystrokes to confirm OCR output in a local or web-based Verification Station. With good form design plus time for the application to “teach” itself, we have often seen accuracy approach the mythical 100% mark.

Template-Based But Flexible Workflows

To the previous point, FlexiCapture can–as its name suggests–accurately extract text from virtually any document imaginable. Structured forms, unstructured documents, handwritten notes…it’s all fair game.

This is valuable when documents are inherently varied, as with all the materials that might support an insurance claim. But clients get the most out of FlexiCapture by using its flexibility for one-off documents alongside fine-tuned templates for recurring ones. This results in nearly zero-effort capture of most forms and a substantial improvement over hand-entering the rest.

Scalability

In some cases, the “paper paralysis” phenomenon is just one symptom of an organization-wide reliance on manual input. In the bigger picture, we want to help clients leverage an EOB-centric OCR tool for automated processing across all workflows and archives.

FlexiCapture comes in two flavors: standalone desktop licenses and a distributed, client-server model. This means that the revenue cycle team can be more seats for OCR EOB processing at the same time that other departments adopt FlexiCapture for their own needs. It scales along with business, plain and simple.

Get Started With OCR EOB Processing

From initial project planning to go-live, many EOB OCR projects with FlexiCapture require just a matter of weeks or months. This is a far cry from the multi-year ordeal that most EHRs deployments involve. In fact, it’s common to recover project costs and actually generate a positive ROI within months of deployment, due largely to the precipitous drop in labor costs.

If you’re ready to explore OCR software for EOB automation in greater depth, or just pick the brain of an expert, then please contact us today. We’re always happy to arrange a free consultation, or even to prepare a live demo using your own, real-life documents!