Resources

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

Delivering Healthcare Payment Electronification

Increased accuracy levels, decreased error rate for healthcare payments posting

Product Videos

See how each product/service module of OrboAnywhere and OrboAccess delivers value from our check and healthcare payment platforms

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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 Reconcilliation

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

Anywhere Payee

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

EDI 835’s Close the Loop for Healthcare Fraud and Compliance

A comprehensive article at RevCycleIntelligence entitled “How Providers Can Detect, Prevent Healthcare Fraud and Abuse” offers insight into ways to “tighten the ship” regarding practices that cost the industry billions of dollars a year.

Complying with the myriad of regulations can be difficult for providers who already focus on a range of priorities, including care delivery, payer compliance, medical billing, and revenue cycle management.

And exactly what constitutes healthcare fraud? According to CMS, healthcare fraud involves the following:

  • Knowingly submitting, or causing to be submitted, false claims or submitting misrepresentations to acquire claims reimbursement from payers for which no entitlement exists
  • Intentionally soliciting, receiving, offering, and/or paying remuneration to encourage or reward referrals for items or services reimbursed by payers
  • Providing prohibited referrals for specific designated health services

And fraud and abuse leads to regulations. The OIG suggested that providers implement the following to address these problems:

  • Development and distribution of written conduct standards and policies that promote the hospital’s commitment to compliance (e.g., by including compliance adherence as part of staff evaluations) and that address areas of potential fraud, such as claims management and financial relationships with other providers
  • Appointment of a Chief Compliance Officer and other compliance staff to monitor the process
  • Implementation of continuous education and training for staff
  • Maintenance of a process to receive healthcare fraud reports and complaints, such as a hotline, and the development of procedures to protect anonymity and whistleblowers from retaliation
  • Establishment of a system to respond to healthcare fraud and abuse accusations
  • Use of audits and/or evaluations to track compliance adherence and help reduce issues
  • Investigation and remediation of systemic problems and the establishment of policies to address if staff involved are retained or terminated

Did you know adoption of solutions which “electronify the paper trail” of remittances and payments help complete the compliance cycle?  Typically data from EOBs and denied claim correspondence is paper-based, and this information is not usually extracted for applications other than pure posting. This can be a major missing data set which would never hit the compliance data analysis engines at a healthcare provider! By converting paper to standard posting data, i.e. EDI 835,  a provider can now reconcile suspected fraudulent claims with remits and payments.

A closed loop system!

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