The Virtual EOB/EOR (Explanation of Review) is an HPAC viewing tool which allows the user to see transactional remittance and claim information on a single page in a standardized format, generated from electronic data.
Because formatting of EOBs and EDI files vary between Payers, healthcare administrators find it difficult to view and locate information from these sources quickly and efficiently. By enabling a standardized layout, billing companies, healthcare providers and lockbox service bureaus can easily access the entire transaction set.
EOBs also include remittance and service line information from multiple claims and patients. Entities must protect patient healthcare information. Many are required to view, print and fax sections of EOBs, which expose the entity to possible HIPAA violations if additional patient information is included.
Uses for the Virtual EOB/EOR include:
- Address research requests which require claims, remittance and payment information
- Simplify secondary and tertiary claims resubmissions by patient information specific to the resubmission
- View, print and fax claim, service lines and payment information on a standardized page with single patient information
- Reduce posting time and complexity by standardizing and displaying EOB/835 information in the cases where provides must still post remittance and payment information manually
Information included in the Virtual EOB is extracted from multiple sources including: 835/837/ACH/checks and EOBs. Transaction information consolidated on the single page include: payment, claim, patient responsibility, claim adjustment details, patient encounter, medical providers, diagnosis codes and service lines.
"By creating a research tool with a standard format, providers can easily locate the information they need for research, posting or claims resubmissions.”
- Phil Hetrick
Healthcare Payments/Revenue Cycle Sales Product Specialist