Automated Workflow for 835 ERA Payment Processsing

Automated Workflow for Payment Processing and Data Validation

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.

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.

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.

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.