Business Partner Solutions

Orbograph business partners have a wide range of analytic capabilities, integrated at various points in the healthcare payment workflow. These analytic capabilities utilize not only native EDI 835 files generated from payers, but also EDI 835 files created by HPAC. By leveraging the output of HPAC, Orbograph business partners deliver critical business value to the revenue cycle across the full range of payments. In many situations, analytic systems have access to only native EDI 835 files feeds, which limit the reporting capabilities to 50-80% of the transactions.

A current HPAC clearinghouse business partner now uses business analytics to aggregate all payment data to analyze gaps between expected and actual reimbursements, assess contract performance by payer and report on payment trends.

Meanwhile a systems integrator offering denials management can provide a comprehensive review of all denied claims, providing new insight to trends by payer, rendering physician as well as CARCs and RARCs.

Testimonial

In addition to creating more efficiency with revenue management, paperResolve enables the physician groups to analyze all remittances and payments for a more robust auditing process. The practice is automatically alerted if they experience recurring shortages in payer reimbursements, such as a payer failing to pay claims in accordance with their provider contract. Adding EOB information into this process completes the payment cycle in addition to the ERAs already processed.”

- Lori Logan
SVP, Trizetto Provider Solutions

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