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!

FlexiCapture Review: Curing Hospital Invoice Woes with FlexiCapture

Invoices were a nagging problem at an otherwise highly efficient hospital in Singapore. Like most hospitals there, it provided excellent care despite the country’s high ratio of citizens per doctor.

The hospital served a disproportionately large number of patients, which also meant a large number of vendor invoices. Its Accounts Payable department handled about 2,000 per day, or roughly half a million per year. As in most organizations, the AP process was monitored with particular scrutiny and had to meet demanding performance standards.

At first, clerks typed names, numbers, line items, and other essential invoice data by hand. This caused far too many errors and, as a result, delayed payments. Given the short deadlines—and potential fines for delay—the error rate was a significant business problem. Continue reading

Game-Changing OCR: Healthcare Forms Automation for Forward-Thinking Providers

In a recent TechCrunch article, one prominent NYC-based physician makes a compelling case for the urgency of technology revolution in healthcare.

She touches on the irony of an industry in which “[w]e could monitor individuals, more closely tracking key biomarkers via wearables” yet, at the same time, “most communications between doctors’ offices come by fax!”

Similarly, she laments how the disconnect between mobile patients and immobile personal data makes it unnecessarily hard to spot disease-prone patients before they develop major symptoms.

The regulatory environment, and the economic incentives that it shapes, are far outside the scope of our daily work as workflow automation consultants.

But there’s at least one key piece of overlap. In the broadest terms, this article describes an industry whose immense manual input–after all, “many healthcare providers are still living a paper-and-pen existence”–is no longer truly necessarily, let alone optimal.
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FlexiCapture Review: A Prescription for Health Document Automation

Though still mired in development challenges, the small but densely populated state of Bangladesh has achieved remarkable improvements in key indicators of public health. Progress in areas such as child mortality, immunization rates, and overall life expectancy has garnered well-deserved recognition for its government and people.

But how do we know that these improvements have actually occurred, or where threats to further progress are arising?

Thanks to the efforts of the Ministry of Health and Family Welfare (MHFW), a national health census has been conducted since 1961. Naturally, forms for all three-plus million households were processed by hand at first, resulting in a two-year data collection process.

A lot can happen in that amount of time. Leaders can go both into and out of office, policies can be implemented and repealed, and health crises can come and pass. Clearly, as technology had improved, such a wait would not suffice. Continue reading

ABBYY FlexiCapture Use Case: OCR for CMS 1500 / HCFA 1500 Forms

Lately, CMS 1500 forms (a.k.a. HCFA 1500 forms) have became one of our clients’ most important automation opportunities. That specific form might not ring a bell if you work outside of the healthcare industry, but it turns out to be a great example of the power, sophistication, and value of ABBYY FlexiCapture software.

By way of background, CMS 1500 forms are the standard paper document with which non-institutional providers (small practices/clinics, for instance) as well as some medical equipment suppliers can bill Medicare. There is also an electronic billing standard, but for various reasons, a vast number of claims are still handled in hard copy.

As most folks are well aware, dealing with a lot of paper can be a tremendous hassle. But add in the critical and highly detailed nature of a medical claims form, as well as sheer volume, and it becomes clear why OCR for CMS 1500 forms so consistently makes sense.

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Sample CMS 1500 form, courtesy of the Centers for Medicare & Medicaid Services
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