OrboGraph
Automating the Healthcare Payment Cycle

It is estimated that manually processing a single healthcare claim costs around $6. In a three trillion dollar U.S. healthcare market, automating these processes can save $9.4 billion per annum, according to the CAQH Index Report of 2016. Yet, the industry is still lagging behind in digitizing its processes and till date, remains a paper-heavy sector.

Taking on the challenge of digitizing the sector, is a company from Billerica, Massachusetts which specializes in payments and recognition technology. It’s intelligent payment automation technology enables OrboAccess modules to serve healthcare providers as well as payment aggregators like clearing houses, banks, practice management systems, hospital information systems, billers, and remittance application vendors. By hastening the process and reducing manual efforts, the solutions shorten revenue cycle of healthcare payments.

“Healthcare payments are very complicated process, including many subcomponents and workflows. Yet, a focused initiative to electronify payments can be very successful by honing in on areas where inefficiencies exist, unit costs are high, and data is accessible. We have made a business case with our solutions that can reduce the unit cost to a range of $0.40 to $1.70 per claim depending on the environment,” says Barry Cohen, Co-President of OrboGraph.

OrboAccess is a cloud-hosted platform solution which not only intercepts the paper but also streamlines the overall payment and reconciliation process of cash. It eases all the painpoints of healthcare billing be it Explanation of Benefits (EOB) conversion, patient payments, correspondence letters, and payment reconciliation. The suite also recently added Denial Intelligences, which offers insights that help providers to proactively identify factors of past data on denials based on value and volume.

Denial process support helps re-prioritize denial worklists based on custom criteria such as the greatest number of denials by source and denial amount ranges.

The healthcare industry also lacks a system to integrate correspondence letters sent by insurance carriers to providers seeking denial claim information into denial management system. It still involves manual phone calls, making it an arduous and time-consuming process. OrboGraph streamlines the workflow by taking scanned images and routing them to select employees for research and resubmission of claims. The solutions also possesses a limitless capability which can scale to address enormous volumes that exist in the healthcare industry.

“One of our top banking clients offers a Medical Lock box service. Our technology enables them to scan EOBs and convert the remittance information into high quality, EDI 835 files with very little overhead for the healthcare provider. It is as close to plug and play as you can get in this sophisticated environment,” says Avikam Baltsan, Co- President and CTO of OrboGraph.

Despite its top-notch solution suite in healthcare payments, OrboGraph has successful line of business in check processing. It works with 1,600+ financial institutions to automate paper-origin documents, be it checks, money orders, and drafts across omnichannel workflows.

The most successful strategy is OrboGraph’s ability to build a network of channel partners. “We anticipate continued, aggressive growth through our channel partners. The demise of paper is dramatically overstated. By taking on the electronification challenge, we are supporting and enabling the market to reduce costs, which is the significant goal all the way up to the highest levels of government,” informs Cohen.

As the healthcare industry provides significant ‘room’ for growth, OrboGraph intends to demonstrate large-scale cost savings of automation as economies of scale kicks in. By providing a standardized approach to solving the medical billing challenges, the company intends to become the industry’s centralized hub to digitize paper transactions.