EMC Introduces New Captiva Software for Accelerated 'EOB' Forms Processing

EMC Corporation, the world leader in information management and storage, today announced the availability of EMC Captiva® InputAccel® for EOBs, a new document capture software solution designed to help healthcare providers streamline and accelerate the processing of explanation of benefit (EOB) forms, reduce errors and the amount of manual intervention typically required to process them, and recover medical procedure revenues otherwise left unclaimed.

Built on EMC Captiva InputAccel, EMC’s flagship document capture software platform, InputAccel for EOBs transforms paper EOBs into digital images from which critical data is automatically extracted, validated and delivered into revenue cycle management (RCM) and other backend systems to facilitate faster reconciliation. The solution employs forms processing and intelligent document recognition technologies to classify incoming documents and from them, immediately extract and export information such as EOB date, remit date, claim number, total charge and tabular line item detail. The solution processes all types of EOB statements, including single page, single account types and single page, multiple account types resulting in very high accuracy rates with little human intervention.

The digital images themselves are then exported to an archive system which is more cost-effective and provides better accessibility than keeping EOBs as paper records. By combining InputAccel for EOBs with EMC Documentum® Archive Services for Imaging software (see separate release), customers benefit from an end-to-end solution that is unified under a common archiving platform for archiving, storing and retrieving digitized EOB forms.

EOBs are the remittance paperwork that accompanies payments from health insurance organizations, known as payers. EOBs list the details of each claim — patients, dates of service, lists of services provided, and amounts billed and paid for each item. Since payers often bundle claims for all members of a health plan, EOBs can be more than 100 pages long and have hundreds of individual claims and thousands of service lines to audit. Health insurance payers may deny benefits if staff members have made data entry errors or entered incorrect medical codes. Various industry studies have shown that if medical providers do not carefully evaluate each EOB, they potentially lose 10 to 20 percent of funds to which they are entitled.

“Processing semi-structured forms such as invoices and EOBs has traditionally posed a problem for organizations because doing so typically requires components of document capture, forms processing and intelligent document classification that the organization may not have,” said Jim Vickers, Captiva Vice President, EMC Software Group. “With our experience in document capture and forms processing, and building on the success we’ve had in offering semi-structured document capture solutions such as EMC Captiva InputAccel for Invoices, we’re able to deliver a new EOB processing solution unlike any other offering on the market today. We believe there is a very big market opportunity for this exciting new input management solution because of the sheer volume of medical claims and EOBs processed.”

According to the Association for Information and Image Management (AIIM), more than 75 million pages of medical claim forms are processed daily in the United States at a cost exceeding $125 million per day, and at least one EOB exists for each claim. The costs to healthcare providers of processing EOBs also can be significant: Medical practitioner and hospital staff members spend 12-80 hours per month matching and submitting paper EOBs with corresponding electronic claims. For health plans, processing EOBs for secondary claims typically requires 100-200 hours per month, according to the Washington Healthcare Forum.

“Processing EOBs has been an ongoing problem for medical providers due to the EOBs’ often complex structure and increasing volumes,” said document imaging analyst and consultant Harvey Spencer, Principal of Harvey Spencer & Associates. “Until quite recently, the technology to automate the processing of EOBs hasn’t been advanced enough to make a serious dent in the costs and lost revenues involved. EMC Captiva’s document capture and forms processing experience and its advanced document recognition technologies position the company to offer a solution that should be well received by healthcare and service providers.”

Several customers have used EMC Captiva software to automate the capture and processing of EOB forms, reduce data entry errors, accelerate EOB processing and recognize revenues that would have been lost due to payment errors.