Claims Processing

Optiform Custom Solutions

Claims Processing

Prioritize the optimization of your medical claims system to ensure a health care process that goes beyond treatment. Minimizing time-intensive tasks and clarifying processes allow healthcare resources to be used as intended, for the benefit of patients. Enable your team to devote the time needed to help patients understand the financial aspects of healthcare using a simplified user-friendly solution.

Accomplish the standard of accuracy in processing medical claims by using our advanced data capture, validation, and conversion software. Capture paper EOB forms and output claim data along with redacted transaction images to post and store in your medical record system. Convert 835 electronic remittance text files into human-readable images.

  • Optiform 835XL

  • Opiform eobXL

  • Optiform 835XL

    The 835XL™ processing utility makes it possible for healthcare providers to generate human-readable images resembling paper explanation of benefit (EOB) forms from 835 electronic remittance advice (ERA). This helps overcome challenges in populating document imaging and workflow systems with image-based documentation. One of the most powerful features of this utility is its ability to produce detailed, patient specific, payment reports from any payer & ERA files. Now, greater efficiencies can be gained by accessing insurance payment information from a single point of view.

  • Opiform eobXL

    The Optiform eobXL™ module provides an unprecedented level of automated data processing capabilities over traditional methods used for paper Explanation of Benefit (EOB) forms. Significantly reduce the labor-intensive task of manually posting cash payments and archiving document images. By utilizing a sophisticated logic engine, the eobXL™ custom module automatically identifies and extracts individual payment transactions and related detail data from scanned images. Data validation and balance reconciliation are performed in the eobXL custom validation module where EOB specific processing tasks are employed. Payment data can be exported to a HIPAA 835 EDI message format and redacted images can be sent to patient folders in a medical record system.