Orbograph E2Post for 835/837 Processing
The Orbograph E2Post service matches and reconciles electronic claim and billing files, typically 837 EDI, with 835 payment files and Electronic Remittance Advices (ERA) from payers (insurance companies) to generate a “post ready” 835 EDI payment file for the Practice Management System (PMS) or Medical AR system of a private practice, hospital, pharmacy or other medical provider. Standard formats for the payment file include ANSI X12 835 EDI. Custom formatting is also available.
Orbograph E2Post utilizes a variety of technologies and process methodologies to ensure data integrity and accuracy of the positing process:
- Automated File Management: 837 claims or HCFA 1500 form data as well as 835 payment files are automatically categorized, indexed and ingested into the Orbograph E2Post workflow.
- Multi-source Correlation Modeling™: Matching and denial logic compares provider claim data to payer payment files and reconciles service lines (claim numbers).
Explanation of Review (EOR): EOR file creation enables provider/biller to review post ready files and identifies potential posting delays as well as problematic patients, denials or payments.
- Incorporates balancing against a remittance payment of checks or EFT
- Adjustment flags
- Multi-claim encounters are detected and supported
File Posting: Reconciled files are made available to the PMS via automated routing or access from the Orbograph P2Post processing center.
Short-term and long-term Electronic Content Management (ECM): Archive with portal access provides secured access to providers or financial institutions for research and reconciliation of both image and electronic file data.
- This merged output is also valuable for contact management as well as AR valuation for cash flow management.
Electronic healthcare payments are burdened with manual review, corrections and posting errors due to lack of systems which can automatically balance and reconcile transactional output from multiple sources. This process adds incremental expense to the core responsibilities of healthcare professionals and often causes billing lags for days or even weeks. Orbograph P2Post streamlines this process and eliminates non-value activities that exist today.
“Our healthcare platform implementation utilizes the most advanced technologies in payment processing, enabling us to create an overall solution that automates the workflow and minimizes manual processes for providers, financial institutions and billers.”
-Avikam Baltsan, Orbograph General Manager and Chief Technology Officer