The payments process within the U.S. healthcare industry is still paper intensive; in fact, McKinsey Quarterly states that more than half of the transactions are paper based. In addition, there is a lag if the payment is paper and the remittance is electronic. Among the challenges that plague the healthcare industry’s quest to automate the payments process are the following factors:
- Because Explanation of Benefit (EOB) forms arrive in many different formats, it is difficult to build automation around the process, and it remains for the most part a manual process.
- In instances where there is electronic remission of remittances, organizations cannot automate handling of 835s that lack all the data required for posting in a Patient Management System (PMS)