Billerica, MA, June 17, 2013 – Orbograph, a premier supplier of recognition solutions for the U.S. check processing market as well as paper and electronic payment solutions for healthcare revenue cycle management, announced today that its white paper, How to Reassociate EFT/ACH Payments to ERAs in 2014, is now available for download at http://www.orbograph.com/reassociate-EFT-ACH-ERS.htm. The white paper explains the challenges and problems which healthcare providers, billers, clearinghouses and financial institutions will need to addresses as The Patient Protection and Affordable Care Act (ACA) supports healthcare payment electronification by defining standards and regulations for ERA and EFT adoption.
Today’s lack of a true remittance standard has resulted in payers (insurance companies) using multiple EOB formats and multiple electronic remittance advice (ERA) remark codes. In many cases, the information that healthcare providers require to reassociate payments and remittances is incorrect, missing, or not provided on the payment or remittance in a way that is meaningful to the provider or its financial institution. As a result, providers are unable to automatically post payments, effectively manage denials and accurately and consistently reconcile their deposited funds.
Additionally, explanation of benefits (EOBs) continue to be utilized as paper-based remittance advices which explain part of the reason why 1.75 billion checks are issued each year for healthcare payments. Although there are now very efficient and cost effective alternatives to convert EOBs, a reconciliation problem still exists.
ACA tries to help resolve this challenge but is only the first step. Within the white paper is a well defined plan on how to realize the full benefits of electronification when utilizing either an EOB or ERA which is electronically generated (referred to as EDI 835). The paper addresses many of the issues healthcare providers are facing including:
- Reduced clerical burden of manual reconciliation so employees can be redeployed on value-add tasks
- Limited reporting of outstanding accounts receivables
- Increased electronic transaction adoption and compliance with standards
- Standardized operating rules for eligibility, claims status, claims payment and remittance, and enrollment and referral authorization
“Unless a healthcare provider or their financial institution can automatically extract and match the TRN data from ACH payment to the remittance information contained within the EDI 835, the process of deposit reconciliation will be manual and cumbersome, and even nearly impossible, as in the case where a provider receives 10 remittances for $100 and eight payments for $100,” stated Barry Cohen, Co-President of Orbograph. “I believe this issue will be a major industry roadblock to EFT/ERA acceptance. As a company that comes from financial transaction processing, Orbograph is ideally positioned to provide a solution that straddles both the financial settlement and healthcare remittance sectors.”
Orbograph (www.orbograph.com), a subsidiary of Orbotech, is a premier provider of recognition services and software for check processing in the financial industry and end-to-end electronic solutions in healthcare revenue cycle management (RCM). Orbograph technologies are in use in over 1,500 financial institutions, service bureaus and billers processing billions of checks and claims annually. Orbograph solutions are utilized by 20 of the top 30 U.S. financial institutions with in-house check processing. In healthcare payments, Orbograph P2Post and Orbograph E2Post utilize innovative EOB conversion technologies to automate posting of receivables into practice management systems. Orbograph enables clients to envision more for their organization by reducing costs and managing risk while ensuring that achieving more is a reality.
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NOTE: Actual performance may vary according to hardware used, configuration or other factors within your processing environment. Statistics cited in this release do not constitute guarantees of performance. For more information, visit us online at www.orbograph.com.