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Optimizing EOB Processing For A Fortune 500 Healthcare Giant

Client

A highly diversified Fortune 500 company into healthcare and well-being business and access to care through networks that include 1.2 million physicians and other health care professionals and approximately 6,500 hospitals and other facilities.


Industry 

Healthcare


Region

United States of America

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Challenges

The client processed 5000 EOBs per day making it 840,000 per year manually. Their TAT was high and needed to be reduced.

The EOBs were in unstructured format as it came from multiples payers in different format so it was difficult to maintain a standard template and record the data. The client wanted the entire process automated.

Solution

Datamatics implemented its smart workflow solution iPM for end-to-end processing of the EOBs including  receipt of hardcopy EOB documents via fax, mail, and/or carrier, scanning, auto data extraction, validation etc.

Datamtics also implemented TruBot to automated the process of data extraction with fuzzy logic and Artificial Intelligence

Impact

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50%

Reduction in EOB processing cost

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90%

Improvement in auto-reconciliation of  claims

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30%

Higher employee productivity, increased processing volumes

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99.5%

Accuracy of information capture