MedValue Automated Payment Posting™ Services

Challenge

Hospitals, Clinics, Medical Billing Companies and Group Medical Practices face a significant challenge every day – Processing the significant amount of remittance paperwork or EOBs received daily, that accompany payments from health insurance payors.

Accurate and timely processing of each EOB is crucial to determine full payment has been received, and the claim can be closed or if it must be resubmitted to the payor. Since EOB data is used to update the remittance processing system and patient medical records, there is often significant data entry involved.

Solution

MedValue has developed an innovative service, which combines our knowledge of the Payment Posting process, with a proprietary software and qualified staff in our Operations Center, to convert your Paper EOBs to an Electronic Remittance Advice (ERA) in EDI ANSI-835 format.

Features

1. Convert Paper EOBs to ERAs in 835 EDI Format
MedValue’s Automated Payment Posting Services provides you with an electronic version of all the EOBs (in ANSI-835 format) which you directly load into your Practice Management and Billing Applications. This eliminates manual Payment Posting and Claim Reconciliation at your end.

2. Submit Secondary Claims with EOBs from Primary
MedValue’s Automated Payment Posting Services also generates Secondary claims and provides you with a package of the Secondary claims and their related EOBs for submitting the claims to the Secondary Payers promptly.

3. Document Management System (DMS)
MedValue’s DMS indexes and provides you with the electronic images of all EOBs and related attachments received, your staff can quickly search by various parameters to either print EOBs for resubmission of claims to payers, or sending secondary claims, or to have effective claim follow-up conversations on the underpaid claims with payers.

DMS also categorizes the underpaid and denied EOBs into several queues. You can now determine the underpaid or denied claims faster and resubmit the claims sooner to improve your cash flow.

4. Reports
MedValue’s Automated Payment Posting Services also provides you with our Workflow Management System (WMS), and various reports such as Payor Cycle Time Report which provides you the information about the Payors are taking to pay your claims, for you to determine if they are meeting their contractual obligations.

Key Benefits

1. Increase Cash Flow and Control
MedValue converts and provides the ANSI-835 file within 2 business days, thereby eliminating manual data entry and reduces errors significantly at your end. You can now determine the underpaid or denied claims faster and resubmit the claims sooner to improve your cash flow. This improves cash-flow as you can now resubmit and follow up on denied and underpaid claims sooner with Payors and increase your cash-flow.

2. Enhance Secondary Payments
MedValue will print the Secondary claims from your medical billing/practice management application, and will provide you with the related EOBs for those claims.

3. Close Books at Month-end sooner
Since MedValue automates your Payment Posting, you can close your books at month-end sooner, as you eliminate manual Payment Posting and reconciliation at your end.

4. Derive Significant Cost Savings
Our services provide savings of approximately 40-60% compared to manual payment posting of EOBs by your staff. Additionally since we provide a quick turnaround for the processing of EOBs received, your staff can work on the underpaid claims or denied claims sooner.

5. Eliminate Paper and Improve Customer Service
Since you and your staff can now search for EOBs and Checks with a click of a mouse, you don’t need to spend time searching through information manually in case of audits or refund requests.

6. Achieve HIPAA Compliance
Leveraging the ANSI-835 formats and our Audit-trail capabilities built into our Document Management System, our service assists you in achieving HIPAA Compliance.

Process

The best part is that to take advantage of our service you do not need to change any of your current software, systems or processes. MedValue’s Automated Payment Posting Service is simple. All you require is one office assistant at the end of the day for an hour or two to scan EOBs and checks to us.

By the start of the next business day, you will receive an electronic file (in the ANSI 835 format) that will be imported into your Practice Management or Medical Billing System (such as NextGen or IDX). Additionally, your staff will now be able to search and retrieve images of all paper EOBs at the click of a mouse through an elegant web interface to our secure and HIPAA compliant Document Management System.

You will also receive a package of Secondary Claims and their associated EOBs on a daily basis so that you can send those claims to Secondary Insurance Payors promptly for processing.

We store images of your paper EOBs for six months on-line on our servers and then burn the data onto CDs and ship them to you for easy storage at the office.

No more handling of paper. Our solution is fast and easy to use. With overnight turnaround of EOB data and secure, instant access to Paper Claim images from anywhere 24*7, you gain improved productivity from your people.