Skip to content

AI Innovation

Both the financial and healthcare industries are undergoing an AI evolution. Review our vision for Artificial Neural Networks (ANN) and deep learning targeting these industries.

AI-Based Check Automation

Check recognition & fraud detection are the most important components in today's check processing and omni-channel capture. Learn how OrboAnywhere using OrbNet AI technology reduces costs and mitigates risk.

AI-Based Healthcare Electronification

OrboAccess, powered by OrbNet AI, provides electronification to remits and payments, enabling RCM companies to automate posting, improve research, and deliver business intelligence

About Us

Celebrating 25 years of innovation, OrboGraph has transformed into an AI company delivering targeted automation solutions to the banking and healthcare industries.

Resources

From news and events to case studies, trends, and videos, this section provides a range of information resources for payment automation in the banking and healthcare industries.

Blogs

OrboGraph produces four blog series on a weekly basis covering topics from check processing, fraud prevention, AI technologies, RCM, and healthcare electronification. Select one the blog to the right. We hope you enjoy!

Artboard-21-copy-compressed

AI-Based Healthcare Electronification

ORBOIMPACT Virtual Conference

AI-Based Healthcare Electronification

The healthcare industry is primed for the adoption of Artificial Intelligence. The applications of AI are virtually limitless, from diagnosis of a patient’s health to automating back-end operations.

According to the 2019 CAQH Index, the healthcare industry can save $13.3 billion—33% of existing annual spending—by transitioning to fully electronic processes. The full adoption of electronic remittance advice (ERA) would save the healthcare industry an estimated $1.9B, as 49% of remittance advice is only partially electronic or fully manual.

To respond to market needs, OrboGraph has invested heavily in AI with deep learning models for the OrboAccess Suite:
EOB conversion software

Access EOB Conversion

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

correspondence

Access Correspondence Letters

Extracts posting data from denial letters, feeding analytics (workflow management optional).

Hosted on the

Healthcare Payment Automation Center (HPAC)

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

Healthcare payment processing

Access Patient Payments

Automate patient payment posting for coupon and check payments.

dashboard on computer screen

Access Denial Intelligence

Comprehensive business intelligence solution analyzing denied claims. 

modern office

Access Payment Reconciliation

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

Join OrboNation

Access to critical updates, new industry insights, & thought leaders.

Modernize & Automate

The full adoption of native electronic ERAs will probably never be achieved; however, electronification of paper-based explanation of benefits forms (EOBs), explanation of payments (EOPs), and correspondence letters powered by AI technologies can enable companies like the following to modernize and achieve nearly 100% automated posting:

  • Revenue cycle companies
  • Clearinghouses 
  • Financial institutions offering a medical lockbox
  • Direct providers
  • BPOs

For electronification, OrboGraph developed a comprehensive suite of healthcare RCM modules as part of its OrboAccess suite.

Only

0%

of remittances are fully electronic

The industry has massive amounts of remittances that are either managed via paper or PDF after downloading from a payer portal. It’s estimated to take an average of 7 minutes to enter a remittance transaction manually.

AI-Based Electronification of EOBs & EOPs

Access EOB Conversion extracts data from scanned images or PDF documents created from paper-based Explanation of Benefits (EOB) or Explanation of Payments (EOP). The system then delivers EDI 835 Electronic Remittance Advice (ERA) files ready for cash posting. This process is referred to as electronification.

Benefits of this process include: 

  • Est. cost per claim reduction from $4.22 (manual) to $1.26 (electronic) – a $2.96 per claim savings
  • Improved efficiency and improved resource allocation
  • Improved data quality for superior postability with reduced patient errors
  • Improved interoperability as EOB data is exportable to downstream denied claim and business intelligence systems

Click image above to watch the Access EOB Conversion Video.

Electronification of Correspondence Letters for Denials Management

Correspondence letters, also referred to as denial letters, represent a variety of health plan/payer communications including, but not limited to, insurance payment denial explanations, additional documentation requests, authorization approvals, authorization rejections, patient medical necessity determinations, bill under review, and legal correspondence.

 

Unfortunately, these letters are typically mailed to healthcare organizations and require manual sorting and manual entry into denial management systems. Function time is consuming, and it can cause delays in payment collection for insurance companies and patients, which drives up receivables.

 

Access Correspondence Letters utilizes OrbNet AI as part of Opti-Lift to extract the necessary fields from scanned images of correspondence letters. Fields include claim ID, insurance company name, correspondence reason, letter date, and patient account number.

 

Workflow management is also available to assign claims to internal staff for denied claim resubmissions.

Click image above to watch the Access EOB Conversion Video.

Benefits of this process include: 

  • Eliminate manual entry of correspondence information
  • Expedite denial appeals, improve efficiencies, and reduce costs
  • Virtually eliminate posting errors
  • Consolidated denial information on HPAC Portal with access to images
  • Reduce receivables and improve collection process
  • Minimize delays in secondary billing
  • Reporting on denial codes and remark code

Medical Lockbox Automation

A lockbox is a treasury management service that simplifies the collection and processing of accounts receivable for the healthcare provider. It’s where the majority of payments and remittances flow, originating from Medicare, Medicaid, and Third-Party Payers into the bank accounts of the health care provider.

Most commonly offered by commercial banks, the lockbox function can also be offered by software companies, RCM companies, and clearinghouses. The Medical Lockbox is an essential part of the AR process as it’s the first touchpoint where paper-originated insurance remittances, payments, and patient payments are received before hitting the bank accounts.

New technologies like AI and deep learning models are evolving these systems into a high-value, innovative platforms that handle not only myriad payments but also paper/pdf remittances facilitating automated, straight-through processing (STP) and payment posting.

The medical lockbox of the future will:

  • Process more native EDI files, but also leverage AI technologies to convert remaining remittances into postable data to achieve 100% electronification
  • Further leverage cloud computing
  • Offer more options and configurations, including fully outsourced, SaaS, in-house via the cloud, or other hybrids

“The OrboAccess Access suite of healthcare payments solutions is a strategic investment for the company. OrboAccess delivers virtually 100% electronification of healthcare payments as part of an industry-wide initiative to reduce healthcare costs.”

-Avikam Baltsan, Co-President and Chief Technology Officer

Review your needs with an OrboGraph expert.

Sign up below for your complimentary assessment or to request
estimated solution pricing from OrboGraph.