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Kevin NealProduct Manager – Production Scanners
Fujitsu Computer Products of America, Inc.Imaging Products Group (IPG)
February 15, 2007
Fujitsu / AnyDoc® EOB (Explanation of Benefits) for Healthcare
Insurance Vertical Webinar
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Agenda
• Introductions of Fujitsu and AnyDoc Software– Kevin Neal, Fujitsu presenter– Megan Fowler, Fujitsu moderator– Jerry Evans, AnyDoc presenter
• Fujitsu, Hospital Admission Facts & Figures– Challenges of EOB processing– Overcoming EOB challenges– Scanner consideration for EOB’s– Fujitsu AnyDoc EOB interpolation
• AnyDoc and AnyDoc EOB overview– AnyDoc corporate– AnyDoc EOB
• Questions and Answers
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Definition of Explanation of Benefits (EOB’s)
• An Explanation of Benefits (EOB) is a statement detailing the medical benefits account activity of an individual or family. After services are received by a covered individual from a doctor, specialist, hospital or other facility an EOB is sent to the individual explaining the services provided and the charges paid and owed.
• EOB– Explanation of Benefits. A statement from a healthcare
provider that itemizes how benefits were approved or denied for a claim.
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Sample of ‘Explanation of Benefit’ form
• Typical ‘John Q Customer’• Fairly well structured form• 27 index fields
• No discernable background dropout color
• Lack of constraint for certain fields
• Densely packed information
• Poor print quality via dot matrix printer on multi-part form
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Challenges of ‘EOB’ processing
• Physical document format– Small font size– Poor print quality
• Time consuming• Labor intensive• Access to information• Form structure• Index fields• Error prone
– Incorrect index– Inaccurate totals
• Lost/misplaced documents• Volume of transactions
Technical
Financial Legal
Procedural
EOB’s present anabundance of
Challenges
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
‘EOBs’ and the Paper Dilemma“…automating the complex process of medical remittance processing
could save tens of billions of dollars in the United States alone.”
• Lockbox processing for Explanation of Benefits article– Offered by banks as a service for high-volume EOB processing– Banks process EOBs themselves or outsource to Service
Bureaus
* Source: http://findarticles.com/p/articles/mi_qa3947/is_200212/ai_n9158745
“The bank collects the remittances, reads them and deposits them directly into the client's account, thus reducing the time required for payment collection, processing, and availability.”
Collect
+Read = Scan/Process
Deposit
Database
Bank
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
‘EOBs’ and the Paper Dilemma• Healthcare remittance volumes are predicted to more than double by
the year 2020 to an annual revenue of more than $26 billion• At the same time, the number of community hospitals in the United
States is projected to decrease by 32% from 4,956 in 2000 to 3,370 in 2020.
• Meanwhile the U.S. population continues to grow-and age. By 2020 the U.S. population over the age of 65 is expected to reach 53.3million, a 51% increase from year 2000 estimates.
* Source: http://findarticles.com/p/articles/mi_qa3947/is_200212/ai_n9158745
Remittance Volume Community Hospitals
Results:Increasing pressureHigher volumes
Need:Greater speedBetter accuracy
Solution:Document scannersEOB processing s/w
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Challenges of ‘EOB’ processing
• 21 key index fields, unstructured form, lack of dropout color
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Overcoming ‘EOB’ processing challenges
• Scanner specific concerns– Speed degradation at optimal 300dpi OCR speeds– Decreased double-sided scanning speeds– Automated forms processing accuracy ratio
• Availability to billing information quickly– Individuals
• AnyDoc EOB ‘snippets’– Insurance providers– Banks/Financials– Legal (Dispute Resolution)
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Fujitsu scanners / AnyDoc® EOB InterpolationScan
Image qualityPaper handling
QAClean images
No double-feeds
Form IdentificationClassification
Security/Rights
Data ExtractionZonal OCRSubtotaling
VerificationDatabase Look-up
Validation
Anchor Points
Remote
Central
BenefitsAvailability
ComplianceService
RegulationReduce Costs
Efficiency
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Paper Orientation of ‘EOB’ forms
• Landscape orientation, scan 20-30% faster!
8.5”
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Scanner considerations in EOB processing
• Physical attributes– Automatic Document Feeder width– Dual interface design/3rd Party Slot upgrades
• Double-feed detection– Length only vs. Ultrasonic DFD– Importance of potential missed billing
• Daily scanning volume– Pages per minute/Images per minute– Scanning at preferred OCR
resolution of 300dpi– Input hopper capacity
• Centralized or De-Centralized scanning
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Fujitsu Scanners / QuickAppTM Interopolation
‘Roping’ Zones“Banding”
Auto-Indexing
When processing an obscure form outside of your standard set oftemplates AnyDoc QuickApp enables fast and effective indexing
ScanImage quality
Paper handling
Remote
Central
Data ExtractionZonal OCRSubtotaling
BenefitsAvailability
ComplianceService
RegulationReduce Costs
Efficiency
VerificationDatabase Look-up
Validation
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Other Fujitsu IT Products in Healthcare
Degaussers
Biometric Authentication
Disk Drives
Gigabit Ethernet Switches
Servers
Scanners
LaptopsTablets
SecurityProductivity
Performance
Compliance
Reliability
Information Lifecycle
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
Old School vs. New School EOB Procedure• Receive paper documents• Document preparation
– Remove staples, etc.• Manual indexing
– 20+ index fields– Varied form structure
• Store documents– Copy information– Proper file location– Share via ‘sneaker-net’
• Retrieve documents– Determine location– Fax files to recipients
• Receive paper documents• Document preparation
– Remove staples, etc.• Automatic indexing
• Store for availability
• Retrieve electronically
40PPM
Speed
$1,000 $5,000 $8,000
15 PPM
$17,000$2,000
25 PPM
$25,000
fi-5750C $7,995-VRS $8,995
fi-4340C $4,995
fi-5220C $1,995
fi-5015C$695
fi-5120C $1,195
60 PPM
fi-4860C $16,995fi-4860C2 $17,995
fi-5530C $3,995
$4,000
fi-5650C $5,995-VRS $6,995
fi-60F A6 FlatbedScanner $395
fi-5110C $895
100+ PPM
fi-5900C $24,995
Fujitsu fi-Series Scanner Line-up
Fujitsu / AnyDoc EOB (Explanation of Benefits) for Healthcare
More information
• Fujitsu Document Scanners– Web Site: http://www.fcpa.com– E-mail: [email protected]– Phone: 888-425-8228
• AnyDoc Software– Web Site: http://www.anydocsoftware.com– E-mail: [email protected] – Phone: 813-222-0414