Associated Data Services,LLP EOB Solutions

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Healthcare

SingleVIEW Methodology

Presented By:

Associated Data Services, LLP

Revenue Cycle Check and Balances for Healthcare Receivables

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Revenue Cycle Check and Balances for Healthcare

We provide a complete Financial Platform that balances and reconciles ALL

Payments with Claims

Our solution is a timely and accurate accounting of all financial transactions for

accelerating the posting and revenue recognition for the provider …

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What we do…• We provide a complete electronic environment• Convert and Process

– ERA’s– Paper – Patient/Self Pays– Correspondence

• Archival & retrieval • Detail level search and analysis• Controlled work queue environments• Balance and Reconciliation• Match and Review through a Single View environment• Generate• Post

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System Highlights• Both ERA and Paper Documents• Paper Portal provides Real-time view• Proven and stable environment

– Over 3m EOB’s processed monthly– Over 16 years in business– No 3rd party software – business totally owned

• We shorten the revenue cycle process by providing NEXT day processing• Highly configurable system

– Designed to conform to customers environment – Configurable business rules– 837 files

• Implementations – 6 weeks or less• SingleVIEW Side-by-Side Comparisons• All transactions stored for 7 years• Complete Search Engine capabilities• HIPAA II Compliant - September, 2010• Auto-Posting

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Process Flow …

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Healthcare Revenue Cycle

Co-pay ClaimCreated Sent to

Clearing House Claim sent To Payer

Payer Review Claim & SubmitPaymentDecision

EOB w/Check

EOB w/ACH

ERA w/Check

ERA/ACH

EOB/Zero Pay

ERA/Zero Pay

Correspondences

BankLockbox

Provider

Secondary

Denials

Self Pay

Write-Off

SingleVIEW

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Islands of Information - Today

Paper EOBs

Bank AccountACH/Checks Deposits

AccountingSystem

(Auto Posting)

Imaging System

Customer ServiceERA’s

Secondary Processing

Denials/AppealProcess

Co-Pay Self Pay

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Healthcare Revenue Cycle Flow

Paper EOB

ERA

Secondary

Correspondences

Denials

Self Pay

Reporting

Co Pay

Input Output

Provider

Payer

Bank

Provider

Payer

Bank

• 837 File• Sample 835 Posting File• Sample Self Pay Posting File• Denial Codes• Co-Pay Information• ERA Files• Secondary Letter• Self Pay Billing File

SingleVIEW

• ERA • Paper EOB• ACH to Bank• Paper Checks• Zero Pays• Correspondences

• EOB Images• ACH Files• Index Files• Rescan Images

• 835 Posting File• Paper EOB• ERA

• Self Pay Posting File• Secondary Processing Files

• Denial Re-submission• Secondary Claims

• Paper• Electronic

• Rescan Request• Billing File for Payment

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ProviderProvider

ERAs 835

PayersPayers

837/Printer Files/ Billing Database

ACH

Consolidated 835

EFTPaper EOBs Check

BANKBANK

Lockbox

Scanned paper EOBs

835

Consolidate 835

Denial Detection

Parsing 837/835/ACH/Printer Files

Secondary Detection

Un-matched Exception Handling

Claim - Remit - Payment Reconciliation

Reports

ERA Processing

CereSoftCereSoft

Paper EOB Conversion

Data validation with Claims

Create 835

EOB Processing

Web portal Status/ Reports

EOB Images

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The Financial Connection

Monthly, Weekly or Daily Financial Summary

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This is paper checks without EOB’s. This tells us there may be ERA’s to be re-associated

This tells us that an EOB arrivesbut without a check

This is the allpaper section thatflows from the lockbox

This is non financialdocuments that are in a paper format

This is EOBs with the payer paying zero amount

This is all the paper

self/private pay

This is where we hadpaper EOB with a check

This shows the totalpayments made with a paper check

This shows the totalpayments made viaan ACH transaction

This shows the totalERA’s process

This shows the total claimsprocess that was matched and un-matched

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There is a Difference

Today With SingleView

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Cash Balancing

SingleVIEW Methodology

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Main View

Cash Balancing

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The ICONS

To view all claims/EOB that are on the system

To view all payments that were process on the system

To view all denials that were process on the system

To view all secondary found during processing of EOB

To view all cash process from all areas from Check, ACH and Patient Pay

To view from the claim type (Paper or ERA or Patient) inbalancing the cash that was process

To view all work that are currently available in allwork queues within the system

To view all the paper that was process that includesPaper EOB, Correspondences, and Patient Pays.

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Cash Posting – Main View

Number ofChecksDeposited

Breakout of Checksto EOB/ERA

Total Patient Claims associated To the Checks

Number that did nothave 837 claims

associated topayment

Total Deposit forall funds

Number of accountsthat had 837 datato match with theEOB and Check

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Cash Balancing – Historical View

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Check Payment View

Click Icon to see claim associated to check

Click Check NumberTo View the Check

Click F under FileTo see 835 Conversion

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Payment View with Check Image

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Account associated to Payment

Click on Account Number to see 835 or Image and the Check

No Claim Paper EOB with Check

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All accounts that were associatedwith the check that were process

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SingleVIEW Methodology837/EOB Image or 835/Check

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DemonstrationCustomer Portal