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Understanding healthcare payment automation, check processing solutions, fraud prevention, and client services

orboaccess healthcare payments

OrboAccess extracts and automates healthcare payment and remittance data for cash posting functions, enables full research access to transactional data and enables business intelligence on a variety of payment sources. OrboAccess drives value to the revenue cycle by completing the electronification of payments from health insurance companies (payers) and patients to the healthcare provider, significantly reducing costs by as much as 50% per claim and improves collections of denied claims.

Access Correspondence Letters extracts index data from scanned images of paper-based correspondence letters typically mailed from payers to healthcare providers. Correspondence, also referred to as denial letters, represent a variety of health plan/payer communications. This includes, 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.

Access Patient Payments extracts transaction data from scanned images of paper-based patient payment coupons/statements as well as check image transaction information to generate EDI 835 cash posting files ready for import to practice management (PM), hospital information systems (HIS) or patient billing systems.

The system extracts the serial number, check amount and date directly from the check. Additionally, the claim ID, account number and patient name can be lifted from the payment coupon or statement.

orboanwhere 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 and compliance. Leveraging a combination of divergent amount recognition (i.e. CAR/LAR, OCR, ICR) and image analysis technologies, OrboAnywhere drives value within image capture across the omnichannel of financial institutions, service bureaus and corporate clients. Our systems are proven to reduce operating costs and fraud losses by as much as 50% and are typically licensed via a termed license of subscription model.

As part of the OrboAnywhere platform and suite of automation, fraud and risk solutions, Anywhere Recognition is leading the industry in check processing platform modernization for financial institutions, service bureaus, and remittance processing providers.

Anywhere Recognition reads and extracts targeted field data on check images captured from scanners or mobile devices. Preauthorized drafts, money orders, internal bank tickets (i.e. general ledger, deposit slips, loan coupons and cash tickets), remittance coupons/stubs and other similar sized documents are also read successfully.

Anywhere Fraud is a specialized module within OrboAnywhere designed to detect check fraud by leveraging image analysis technologies based on OrbNet Forensic AI. This digital image forensic inspection is typically blended with transactional analysis, interrogating the attributes of on-us check images and metadata.

On-us items also enter the omni-channel via teller/branch, mobile, and ATM channels. In these situations, real-time detection can help stop fraudulent check cashing and cash withdrawals within split deposits.

Preventing deposit fraud is a specialized and difficult challenge for many financial institutions due to the nature of transit checks. FI’s use a variety of approaches ranging from 100% manual review to fraud filters or machine learning. Many deploy payment and deposit verification services as well. Unfortunately, counterfeit, forged, and altered checks many times go undetected.

OrboGraph detects deposit fraud via the use of multiple OrboAnywhere modules including; Anywhere Fraud, Anywhere Validate, and Anywhere Payee. These modules rely on image forensics (OrbNet Forensic AI) and image recognition (OrbNet AI) to deliver a unique blend of protection to the FI and its clients on deposited items.

Check fraud continues to be a persistent industry problem due to a reliance on transactional analysis systems. This approach severely limits a financial institution’s capability to detect counterfeit, forged, and altered checks without the use of image forensics.

Anywhere Fraud is a specialized module within OrboAnywhere designed to detect check fraud by leveraging image analysis technologies based on OrbNet Forensic AI. This digital image forensic inspection is typically blended with transactional analysis, interrogating the attributes of on-us and deposit/transit check images and metadata.

Anywhere Validate is a risk scoring and data extraction solution which automatically validates the negotiability of paper-originated items from any self-service, centralized/distributed capture channel or image exchange trading partner within the omnichannel of a financial institution. Designed to minimize the risk of checks and cash equivalent images from being non-negotiable, the system delivers a more comprehensive approach compared to traditional image usability testing or manual review.

Traditional Recognition and Fraud Solutions

Accura XV, our 15th anniversary check recognition solution, is field proven delivering hundreds of clients over 90% read rate with 99% accuracy across a wide range of scanners and diverse bank document mix. Check read rates in version 1.2 have climbed to as high as 95% depending on the mix. Additionally, Accura XV-based image quality/usability (IQUA) tests improve detection rates of image defects.

Now with OrboGraph\'s new Next Generation Recognition Technology, Accura XV\'s V100 mode attains virtually 100% read rates on small transactions in Teller Image Capture. Meanwhile, large transaction misread levels can be tuned to as low as 2 per 1000 items.

ATMs have evolved from simple cash dispensers and check deposit devices to offering a myriad of multi-channel payment options along with advanced imaging and receipt capabilities. As financial institutions and retail stores expand on self service functionality, ATM\'s and kiosks can provide incremental value to consumers and streamline staffing models. Now is the time to utilize new technologies in check recognition which can validate the fields of the check, improve automation and accuracy, reduce fraud risk and improve the user experience.

Managed Recognition was created by the OrboGraph Client Services group as a value-added process to ensure exceptional field performance of Automation Services and Automation Services LE . We observed how customer field performance can deteriorate due to considerations of live production including scanner quality, document design and image friendliness, new documents, proper confidence level setting, document templates, item preparation, stamping procedures by tellers and varying validations.

OrboGraph IQUA, Image Quality (IQ)/Image Usability (IU)/Image Integrity (II) modules provide a comprehensive solution for identifying substandard check image quality (also referred to as Non-Compliant Images or NCI), unusable fields or images which mismatch the MICR index. By applying these capabilities, the capture system resident in a wide range of workflows can ensure that the check image captured meets the quality and warranty requirements for image exchange and Check 21 for each given exchange partner.

Defective images can increase risk of exposure and become an expensive adjustment process if not identified upstream in the check processing workflow.

Automated Endorsement Analysis (AEA) uses advanced image analysis techniques to scan the back of check images to ensure valid endorsements. By detecting endorsements systematically, financial institutions are better able to manage the risk of check fraud, minimize bank-to-bank litigation, reduce dollar thresholds, as well as comply with industry regulations. OrboGraph\'s Automated Endorsement Analysis allows a depository bank to test virtually every check prior to clearing as a means to mitigate risk.

OrboGraph\'s Amount Verification (AV) module identifies both incoming and outgoing check images with incorrect amounts. AV has the ability to reduce the number of incorrect amounts (defects) to six sigma levels of accuracy (3.4 per million or 99.99966% of the checks are statistically expected to have the correct amount) with coverage of 95%+ of the checks.

Payee Name Verification (PNV) provides payee verification to positive pay systems. OrboGraph recognition technologies are applied to match payee names (and address when available) on a check with customer issue file names. The result is a sophisticated technique to minimize risk for financial institutions and your corporate customers.

Banks rely on check images for not only the payment clearing function, but for fraud prevention as well as services tailored to corporate accounts.

Most large banks offer positive pay services to corporate clients in order to mitigate the risk of check fraud on these accounts. Unfortunately, alterations to the payee are not detected with traditional positive pay matching routines, as 52% of all organizations who encountered at least one check fraud attempt experienced payee name alteration on issued checks, according to the 2014 AFP Payments Fraud and Control Survey.

Additionally, community banks are feeling the \"pressure\" from corporate customers to offer additional treasury products and services, because large banks are aggressively targeting this market for new business clients.

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