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Taskmaster EOBs

Taskmaster for EOBs

Hospitals and group medical practices – commonly called Providers - face a significant capture challenge every day: processing the remittance paperwork that accompanies payment from health insurance carriers, a document known as an Explanation of Benefits (EOB).

Healthcare providers need fast and accurate processing of each EOB to determine if full payment has been received and if the claim can be closed or if it must be resubmitted. EOB data is used to update the remittance processing system and patient medical records, and since EOBs are often hundreds of pages long, with multiple patients and services listed, there is often significant data entry involved.

Taskmaster for EOBs

Taskmaster for EOBs can streamline and automate EOB review and data entry, enabling healthcare providers to quickly credit payments and identify claims that have not been fully paid.

Taskmaster for EOBs can help your organization:

  • Increase data entry efficiency and accuracy
  • Ensure complete Remittance Advice transactions are delivered to your accounts receivable system
  • Balance EOBs to check received
  • Index EOB images for archival purposes
  • Successfully exports data in 835 format

Taskmaster for EOBs uses optical character recognition (OCR) to identify data from scanned EOB's, then uses validations and math calculations to total the transaction line items and compare them to each subtotal to ensure balanced patient information.
Taskmaster for EOBs provides productivity tools to speed processing and assure accurate data entry. EOB processors view a verification panel that enables them to quickly check each claim and service line and fix low confidence characters or enter data when required. Lines that do not balance are highlighted in red for an operator to quickly determine a course of action. Finally, all data is properly formatted in HIPAA-compliant 835 standard EDI for delivery to your remittance processing and patient records systems.

Taskmaster for EOBs automates the processing of EOB’s for Providers, significantly increases speed and accuracy, eliminates manual data entry, and saves your company money.

 

What is an EOB?

When health insurance organizations – commonly called Payers – adjudicate a medical claim, they send the Provider payment with an EOB, which lists the details of each claim – patients, dates of service and a list of services provided.

The EOB details the amount billed, and paid for each claim, with an explanation of the benefits covered. Depending on the business rules of the Payer, benefits can be denied simply because the wrong box was checked on a claim, or the wrong CPT code was used. If Providers don’t carefully evaluate each EOB, they potentially lose 10% to 20% of funds for which they are entitled.

Payers often bundle together claims for all members of a plan who have had services by the Provider within a given time period. As a result, EOB’s can be 100 pages or more, with hundreds of individual claims and thousands of service lines to audit.