Category Archives: Payment Processing

Automated EDI Splitting & Parsing Technology

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RCMS specializes in working with remittances containing multiple Tax ID/EINs and NPIs in a multi-submitter, single receiver business environment. With the use of workflow automation and AI, commingled ERA files are captured, ingested, and matched against corresponding bank deposits. Whenever possible, we also match 835 remittances to their associated 837 claim feeds.

Once the data has been matched, validated and reconciled to the batch/check/deposit totals, RCMS parses/splits and segments the data to the corresponding host billing system/clearinghouse by TIN, NPI or HAR* for posting and reporting purposes; all while ensuring the parsed data balances and reconciles back to the originating batch and deposit. We can also capture and process data from multiple bank accounts and multiple clearinghouses, with each deposited item associated to its corresponding account and/or lockbox. 

Outsourced Remittance Processing and EDI Splitting for Physician Practice Groups, MSOs, Hospitals and Health Systems

Offering a unique blend of services + technology, RCMS also provides splitting services to ReMedics clients, our sister-company and BPO Business Partner, using the ReSolve® AI & Workflow Automation platform. From Lockbox Payment Processing to Bank Reconciliation and Funds Distribution, ReMedics can assist you with a variety of customized revenue cycle outsourcing services. ReMedics also ensures that correct information is applied to your patient accounting system by scrubbing data prior to uploading.

Contact RCMS About Your Commingled 835 Files

Through custom configuration and multi-level splitting logic contained within our ReSolve® workflow solution, commingled ERA files are efficiently assigned to the appropriate EMR or PM system. Contact RCMS today to learn more about all of our remittance processing, data validation and treasury reconciliation solutions. Contact us online — or call 440–671–7750.

RCMS, LLC is the technology sister company of ReMedics, LLC with common ownership. ReSolve® is a registered service mark of RCMS with the United States Patent and Trademark Office (USPTO).

*Within healthcare’s revenue cycle management (RCM) processes, the Taxpayer Identification Number (TIN), National Provider Identifier (NPI), and Healthcare Administration Record (HAR) are each used to identify individual providers and organizations for administrative and financial transactions.

A version of this article was also published by ReMedics on 2/04/2024.

Automated Workflow for 835 ERA Payment Processsing

Automated Workflow for Payment Processing and Data Validation

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Using Artificial Intelligence (AI) and Robotic Process Automation (RPA) for Efficient Processing of ERA and Paper-Based Remittances.

ReSolve® Payment Processing provides for the efficient capture, management, and use of all patient, government and third-party insurance payment data to dramatically improve posting accuracy and exceed benchmarks. Our Payment Processing solutions integrate with existing host billing systems, through a variety of Data Capture, Artificial Intelligence (AI), and Robotic Process Automation (RPA) systems integration methodologies; thereby allowing for efficient and accurate processing of both ERA/EDI and paper-based remittances. Once complete, the system sends transactions directly to the billing system using native 835 file integration or client-definable RPA technology while monitoring denials and other conditions.

Data Scrubbing Prior to Posting

ReSolve® Payment Validation helps to correct any errors in remittance data prior to posting, regardless of how the data was captured. This automated workflow process is used to validate the entirety of information needed for processing, thus improving data integrity.

Once all information is captured, ReSolve’s Payment Validation begins analyzing the data with over 200 available client-definable business rules to scrub and cleanse potential errors prior to posting, while routing any errors back to exception work queues for user correction.

Revenue Cycle Reporting with Microsoft SSRS and Power BI

ReSolve® Reporting & Data Analytics unlocks the potential of your extensive data generated as a result of revenue cycle processes and workflows. Our platform provides for the automation, scheduling and distribution of reports on a daily, weekly, or monthly schedule via network share, email, SFTP and other delivery options.

With integration to Microsoft SSRS and Power BI tools, authorized users can tailor their own reports and scorecards with a ‘drag and drop’ interface, enabling managers to dynamically see report layouts as they are created.

Working with RCMS

RCMS brings decades of healthcare business office and workflow automation experience to improve your revenue cycle. We specialize in working with Healthcare Systems and IDNs having a Central Business Office (CBO) for processing payments across multiple EMRs and Practice Management systems. Contact RCMS for an assessment of your remittance and treasury reconciliation processes and how you can benefit from our solutions.