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Check out our reservoir of information related to check recognition and healthcare payment technologies. We frequently update this section with the latest news, trends, and analysis of the banking and healthcare industries.

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Platform Modernization

Both the financial and healthcare industries are undergoing modernization initiatives in check payments and remittance.  See how OrboGraph is using AI, self-learning and deep learning models to drive innovation in these industries to deliver workflow automation.

Platform Modernization

Modernizing payments in the banking and healthcare industries

AI, Self Learning & Deep Learning Technologies

Optimized AI and deep learning models for the automation of check processing and healthcare posting

Operationalizing AI & Self Learning in Checks

Revolutionizing check processing and fraud prevention for the banking industry

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Increased accuracy levels, decreased error rate for healthcare payments posting

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Healthcare Payments

OrboAccess automates remittance and payment posting as well as enables full research and business intelligence analysis for RCM companies, clearinghouses, billers, and providers.

Access EOB Conversion

Delivers EOB/EOP electronification with information intelligence via AI and deep learning technologies

Access Correspondence Letters

Extracts posting data and tracks reimbursement progress via workflow management

Access Payment Reconciliation

Streamlines the reconciliation process of ERA, ACH, EOB and checks

Access Patient Payments

Automates patient payments for posting

Access Denial Intelligence

Spotlights trends in denials to reduce receivables via prevention

Healthcare Payments Automation Center

Scalable, reliable, flexible cloud-based hosted data center on Amazon Web Services (AWS)

Check Processing

OrboAnywhere automates paper originated payments (i.e. checks, money orders, drafts) and remittances for balancing and posting while reducing risk and losses in the areas of check fraud, payment negotiability and compliance.

Anywhere Fraud

Transaction and image analysis for on-us and deposit fraud detection of counterfeits, forgeries, and alterations.

Anywhere Recognition

Divergent multi-engine CAR/LAR, ICR, OCR & AI check recognition for the Omnichannel

Anywhere Validate

Validate payment negotiability of paper originated items

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Match, read, and validate payees for risk and operational workflows

Anywhere Positive Pay

Payee name verification of business checks using issue files

Anywhere Compliance

Mitigate risk in check payments for OFAC, BSA/AML, UCC, Reg CC, and KYC

Restrictive Endorsement

Automatic validation of restrictive, mobile and non-restrictive endorsements

Traditional Products

Based on the Accura XV platform

CPAP Denials Are A Bigger Deal Than You Thought.

Earlier this year, The Huffington Post reported on the largely negative impact Medicare regulations are having on CPAP users and providers.

On the provider side specifically, CPAP denials have been known to top denials lists for HME and DME suppliers, meaning that understanding the layers of Medicare’s logic is the first step in understanding how CPAP denials subject any facility’s cashflows to unnecessary risk.

An Excessive Level of Regulation

As things stand, CPAP supplies are regulated more tightly than OxyContin prescriptions with Medicare having the strictest policies of any payer reimbursing CPAP for OSA (obstructive sleep apnea) treatment. That level of regulation results not only in denials but also indirectly encourages:

  • The repossession of CPAP machines from patients
  • Delays in the administration of equipment
  • Denial of the continuation of treatment for patients who’ve been long-time users

When you take a closer look at the requirements, those outcomes are not surprising. For a patient to qualify for OSA treatment, they’re forced through a twisting and somewhat controversial process:

  • …They start with an in-person encounter with a physician who then documents their concern for OSA and initiates a referral for a sleep study.
  • …The results of that study must then indicate the presence of OSA, strictly by Medicare’s definition (which as of early 2017, did not align with the American Academy of Sleep Medicine’s rationale.)
  • …If a patient is then approved for a CPAP device, compliance is tracked for 90 days.
  • …If they don’t demonstrate compliance within that time, the device must be returned. In order to qualify for a new device (if the patient wants to) they have to repeat the process from the beginning.

Are These Good Results?

On its surface, Medicare’s logic looks sound—almost half of the patients who are prescribed CPAP use will quit within the first year. But the impact often leaves patients frustrated and providers wary of denials and audits. If Medicare finds an irregularity in DME paperwork, they can require a full refund on equipment and in some cases, even begin to audit claims from the DME provider.

Before establishing a policy to avoid unnecessary audits and denials, most providers need to analyze the history of CPAP denials and see where they have room to implement proactive denial correction. The first step in that process? Stepping away from manual, low-insight approaches and treating denials trends seriously through the use of tools like Access Denial Intelligence.

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