Orbograph P2Post for Explanation of Benefits (EOB) Processing

The Orbograph P2Post solution optimizes revenue cycle management by utilizing OCR software to convert paper Explanation of Benefits (EOB) forms into an electronic file or ERA (Electronic Remittance Advice), matching the output with billing files (837), then generating a “post ready” payment file for the Practice Management System (PMS) 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. Typically, Orbograph P2Post is configured to perform this process in a matter of hours.

Orbograph P2Post utilizes a variety of technologies and process methodologies including:

1. EOB conversion leverages best-of-breed Orbograph OCR/ICR, workflow and data verification technologies to address unique EOB attributes such as:
• Field labels and field names with distinctive abbreviations
• Varying data element structures
• EOB field locations and column headers
• Service (claim) line formatting can vary
• Single or multiple row formatting
• Page length fluctuations
2. Automated Cross Tab (tabulation) balances and validates EOB data lifted from the image using business rules including:
• Cross tab totaling by row and column
• Balancing against a remittance payment of checks or EFT
• Adjustment flags
• Multi-claim encounters are detected and supported
3. Multi-source Correlation Modeling™: When the 837 (claim) is available, Orbograph modeling algorithms merge this EDI file with the 835 extract of the EOB for more complete and accurate posting. This merged output is also valuable for denials and contact management, as well as AR valuation for cash flow management.
4. 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.

Manual EOB posting is fraught with inefficiencies, high unit costs and posting errors due to a complex multi-step process of data entry, balancing and business rule validation. Orbograph P2Post offers a new way processing which accelerates collections, minimizes delays in secondary billing, streamlines the process of working denials and improves the cash position of the provider.

“Our underlying technology is unique to the industry and provides our clients with reliability, speed and accessibility. Coupled with our client-focused Client Services group, this service provides world-class EOB conversion services and a comprehensive solution. Additionally, we utilize several HIPAA compliant components which many organizations have in place today.”

-Bryan Bruton, Technology Business Executive, Healthcare Solutions of Orbograph