Datamatics Solution, powered by i-Q software, takes the pain out of EOB processing for a US-based state healthcare program

Feb 18, 2010 10:00:00 AM

Mumbai, February 18, 2010: Datamatics' EOB Processing Solution, powered by i-Q© smarter document processing tool, has delivered superior benefits to a US-based state healthcare program. Apart from cutting EOB processing costs by half, the solution has also accelerated processing cycle times by two times. Other improvements included faster and error-free reconciliation of payments received from insurance companies against claims submitted, which in turn has been driving efficiencies in its cash flow and accounts receivables.

The solution's success is due to the artificial intelligence / fuzzy logic that drives i-Q©. Till the installation of the Datamatics EOB Processing Solution, the healthcare program was grappling with spiraling document processing costs that contributed to the overall healthcare costs, slow document processing cycle times and numerous errors in the manual document processing process.

The end-to-end EOB Processing Solution (also used for Explanation of Payment and Electronic Remittance Advice) processes EOBs / EOPs / ERAs right from the receipt of the printed document at the healthcare program's offices. Using i-Q, the EOB Processing Solution extracts data, validates and converts it into EDI 835, searchable PDF or any other format. The data is then exported to enterprise applications for further back-end processing, delivered via the Document Archival, Retrieval and Tracking System and used for customized MIS reports.

i-Q©, developed by Datamatics Global Services, uses fuzzy logic / artificial intelligence to intelligently locate, identify, capture, extract and validate information from the EOBs, which are complex unstructured documents. The validation of the data occurs parallel to the data capture phase impacting the processing cycle time. i-Q© avoids repetitive errors and learns new error patterns, bringing the accuracy of the validation to 99.5%.

Punit Jain, Global Head – iQ and Document Processing BPO, Datamatics Global Services, said, "Healthcare providers manage millions of subscribers, and an EOB is received from the insurance company for every procedure that each patient undergoes. This demands that their claims are processed quickly and accurately while controlling the processing costs. The EOB Solution deliver these benefits – quick, accurate and cost-effective processing of EOB documents, taking the pain out of claims processing and reconciliation of payments. Through capture outsourcing services, we also take the painful and complex paper processing task out of the healthcare providers."

Rahul Kanodia, Vice Chairman and CEO, Datamatics Global Services, said, "Healthcare is an important focus area for Datamatics. Over the years, we have invested in developing intelligent technology solutions customized to deliver immense benefits for the healthcare industry. We have considered the drain on revenues and profits that healthcare providers suffer due to the inefficient processing of documents. The cost savings from implementing the EOB Solution, powered by i-Q, can run into billions of dollars. By eradicating paper EOBs, the solution also drives the green initiatives at our client organizations. Research says that over 60% of EOBs are processed in paper form."

The EOB Solution, powered by i-Q©, is being showcased at the Datamatics Global Services booth #8501 at the HIMSS10 Expo, March 1 – 4, Atlanta, Georgia World Congress Center.

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