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Eligibility and EOBs: Look to Automation to Improve Efficiencies

You might not think twice about the ability to receive electronic remittance advice (ERA) from large payers. But what about those smaller payers or self-insured companies that still send paper EOBs? If even a small percentage of your payers use paper EOBs, it might be time to explore the bottom-line benefits of automating your EOB processing and reporting.

That’s what some practices are finding as they partner with a clearinghouse to scan paper EOBs and convert them into electronic images. Capturing the ERA and EOB information electronically allows for faster reporting on ERA in its entirety by covering both paper and electronic remittance. Through this process, one Georgia practice has saved several FTEs by turning to automation to tackle its 25 percent of EOBs delivered on paper.

The same holds true for automating eligibility verification—a process that should occur at registration or before. The same Georgia practice uses its clearinghouse to perform eligibility verification, but has also made sure to integrate the information with its practice management and check-in systems. As a result, patients can view their current eligibility information, co-pays and more as they register for appointments.

As illustrated by this group and others—including a Louisiana urology group we told you about earlier that has dramatically reduced A/R days—leveraging IT to automate eligibility and EOB workflows can quickly pay off on the bottom line.

You can read more about this Georgia practice in a recent Health Data Management article. After you register and read, let us know what your practice is doing to improve eligibility and EOB workflows. How has automation helped your processes?