Every medical practice and healthcare provider must cope with a mountain of explanation of benefits statements, as experts estimate that a mind-boggling 75 million pages of medical claims are processed every day in the United States. A medical explanation of benefit (EOB) is a statement that spells out in detail the medical benefits paid by an insurance company on behalf of a patient. The EOB is not a bill; rather, it delineates the parts of the bill that the insurance company has already paid to the healthcare provider, and what part of the bill the patient is responsible for paying. Many of these EOBs contain information covering multiple patients and can be more than one-hundred pages in length. This creates a laborious manual posting procedure which can delay billing by days.
Efficient EOB Processing
One of the inherent benefits of DIS-Imaging™ is the ability to find and retrieve documents from your desktop PC and view the document on your computer screen. Your billing department will be able to locate a patient from within a database of EOBs instantly, improving the speed and efficiency at which an organization can process patient benefit information. To further streamline the process, DIS-Imaging™ offers
freehand zone OCR (Optical Character Recognition), which allows you to select text from different areas of the EOB to be used in the document retrieval process. DISImaging ™ provides the flexibility to select as much or as little of the text from multiple locations within the document and add it to the label for retrieval purposes. Because
a practice receives EOBs from multiple insurance companies, each with its own unique format for displaying information, the ability to OCR specific regions on the fly for labeling purposes is a significant benefit to any organization.
Summary of Benefits
By improving the speed and efficiency at which an organization processes patient benefit information, we can improve cash flow and reduce costs. Benefits include: Increased productivity – more EOBs are processed in a shorter period of time. Improved cash management – faster generation of critical payment data and outgoing invoices makes revenue available more quickly to healthcare organizations.
Truncated business cycles from increased productivity – other healthcare management
processes dependent on content extraction from EOB documents are reduced.
Improved customer service – fast and accurate EOB processing equates to more customers getting served in less time, with fewer payment errors.
Improved employee morale – making document search and retrieval easier leads to less stress and improved morale.
University of Massachusetts Medical Center Study
An analysis was performed by the University of Massachusetts Medical Center to measure the actual dollar value of lost information to the medical center. Over a twoweek period, the file staff filled out a form for each request to retrieve a document from the storage room, documenting the total number of files requested and the result
of each request. The study found that 11% of the documents needed to process a claim were missing, resulting in the amount charged on the claim going unpaid. The most common reason for non-payment is co-insurance (spouse policies and automobile policies) and re-insurance that were usually resolved in favor of the medical center once the proper documentation is sent to the third party payer. Procedure code disputes also occur and were often resolved in the medical center’s favor. The impact of missing documents was significant. According to their findings, the Medical Center was unable to locate 146 documents per month, with an average lost billing of $501 each. Statistically they collected 80% of projected revenue, equating to a probable loss of $58,517 per month (146 x $501 x 80%) or $702,000 annually. DIS-Imaging™ can help regain those losses by improved documentation and elimination of lost or missing documents.
Scalability of DIS system to Accommodate Specific Departments
Some physicians or clinics may not feel comfortable with the full implementation of an electronic medical record system into their practice, and would prefer a gradual addition of technology. Because DIS-Imaging™ can have such a significant impact on billings, a clinic might want to consider starting with its billing department. The return on investment is fast, it does not disrupt the rest of the practice, and is a welcome addition to the billing staff because of the increased efficiency of the organization.
Optimize EOB Management with a Document Imaging System
Paper Filing System vs. Document
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• 75 million pages of medical
claims are processed every
day in the United States.
• Billing departments will be
able to locate a patient EOB
• DIS-Imaging™ offers freehand
zone OCR on the fly
for accelerated labeling and
Increase the Efficiency of EOB Management.
• Increased efficiencies with
EOB management equate to
increased net revenue.
• Better documentation of
EOBs improves customer
service with fewer payment
• On average, 11% of medical
documentation is missing,
resulting in unpaid claims.
• DIS-Imaging™ can be
scaled to integrate into any
department or the complete
Provide a Better Experience for Your
Patients by Improved Billing Services.
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