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Automating Remittance Advice Posting in Meditech

SphereGen Case Study

Processing Electronic Remittance Advice (ERA) and posting payments is a step in the Revenue Cycle which takes time and focus, as each payment received must be matched to a claim. Errors in this process can result in misapplied payments which translate into hours spent fixing the error.

Our client automated their ERA payment posting in Meditech and are experiencing greater accuracy and significant times savings every day.

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Automating
Remittance
Advice Posting in Meditech

SphereGen Case Study

Processing Electronic Remittance Advice (ERA) and posting payments is a step in the Revenue Cycle which takes time and focus, as each payment received must be matched to a claim. Errors in this process can result in misapplied payments which translate into hours spent fixing the error.

Our client automated their ERA payment posting in Meditech and are experiencing greater accuracy and significant times savings every day.

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O V E R V I E W

Processing the Electronic Remittance Advice (ERA) associated with Explanation of Benefits (EOB) is a detail-oriented task requiring the syncing of multiple transactions. For our client, this synchronization also had to be accomplished across the integration of three systems – Meditech, Trubridge and their bank.

By automating the electronic process, the Revenue Cycle Team now focuses on exceptions, those ERA transactions which have no corresponding match and cannot be posted, and paper check payments. This automation saves them over 40 hours each week and has significantly reduced the possibility of applying a payment to the wrong patient.

Challenges

When processing an ERA, our client had to work across three systems. Beginning with a bank statement, transactions needed to be cross-referenced to Trubridge and then to Meditech. Once a transaction could be posted successfully, records of the payment were printed and filed. Any transactions which could not be processed were held for further research and error resolution.

Depending on the number of transactions to be posted, this process could take between 7- 8 hours each day. Working on any transactions in error took even more time out of the day.

SOLUTION

To reduce the total time and effort required to post remittances, SphereGen created an automation which crosschecks all incoming remittances to existing claims and posts the payment. All remittances are filed electronically for historical record keeping. If any errors are found within the process, the transactions are skipped and marked for error so the Revenue Cycle team can go back and reprocess them. The automation also checks prior remittance batch files to ensure that all transactions have posted status. If any records remain open, a report is produced and emailed to the appropriate team member alerting them to unprocessed transactions.

This automation saves our client’s team over 40 hours each week. In addition, all posted files are now stored electronically, eliminating the need for paper filing. Overall process accuracy has increased, and exceptions are resolved more quickly.

RESULTS

Overall
Time Saved
0 hrs/day
ERA
Automation
0 %
Increased Productivity
due to Task Shifting
0 %

THE DETAILS

APPROACH

Cross-check and Post Transactions

To successfully post remittance payments, the automation must crosscheck transactions between three systems. Beginning with an electronic file of remittance advice, the automated bot reads each transaction. Using the amount and tracking number, the bot accesses the Trubridge system and locates the transaction. Once completed, the transaction is matched to the claim in Meditech. If all information cross-checks, the payment is posted.

File Posted Transactions and Email Status Notifications

Once a transaction has been confirmed to have a posted status, an electronic copy of the remittance transaction is created and filed. If any transactions cannot be posted, the bot copies this information to a report. The report is sent to the appropriate team member for research and correction.

In addition, the bot checks all historical transactions within a particular time frame. If any transactions in this period are found to have a status other than posted, the information is included in a report to the Revenue Cycle team, so they are aware that unposted remittances exist for prior days.

CONCLUSION

As a result of automating the Remittance Posting process, our client was able to realize benefits in these areas:

  • Time Savings of 40+ hours/week
  • Increased Productivity from time savings and faster error resolution 
  • Increased accuracy, record keeping and reporting

Time savings increased in two areas. First, the automation can be run as soon as the bank statement is uploaded. Since the automation completes in a much shorter time frame than manual remittance processing, exceptions can be worked early in the morning. This clears the way for all other processing throughout the day.

With time savings and less manual effort, staff are happier to have more time to devote to clearing errors and completing even more tasks during the day.

Since our client has been automating several parts of the Revenue Cycle, the time savings realized throughout these automations has made a substantial impact in improving the overall efficiency of the Revenue process.

SphereGen is a technology company that specializes in developing innovative solutions in healthcare to improve patient experiences and outcomes. Our customer-centric approach focuses on finding the right solution to meet the need at hand, using technologies like Intelligent Automation to improve workflow and productivity. In support of general Healthcare requirements, we also offer custom software services in Application Modernization/Support and Extended Reality.

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