Delivering Healthcare Payment Electronification
The healthcare industry is striving to achieve 100% electronification of payments and remittances. Despite the efforts of the government to semi-mandate insurance companies, payers and providers to exclusively utilize EDI 835 electronic remittance advices (ERA) and ACH payments, the industry still generates billions of claim payments in checks with EOB remittances in the form of PDF or paper-originated transactions.
To process these documents, providers, service bureaus, and RCM companies utilize a variety of methods to cope with these unpostable transactions, typically relying on outdated data entry infrastructures. Modernization is now available via the use of AI and Deep Learning technologies hosted by cloud computing.