OPIFORM EOBXL

Optiform eobXL is a solution offered by Optiform that aims to automate the processing of Explanation of Benefits (EOB) forms using machine print recognition technologies. According to the vendor, this software solution is designed to streamline the data extraction and integration process, potentially accelerating billing cycles and reducing manual data entry tasks. Optiform eobXL is targeted at healthcare providers of various sizes, from small clinics to large hospitals and healthcare organizations. It is used by professionals and industries such as healthcare providers, medical billing companies, insurance companies, revenue cycle management companies, and healthcare administrators.

Key Features

User-Friendly Setup and Administration: According to the vendor, Optiform eobXL provides a user-friendly interface that allows end-users to easily configure the classification, extraction, data validation, and reconciliation rules.

HIPAA Compliant Batch Management: The vendor claims that the solution ensures a secure scanning and batch management environment that complies with HIPAA requirements, maintaining patient privacy.

Semi-Structured Forms Processing Engine: According to the vendor, Optiform eobXL features a powerful engine capable of locating machine printed data elements within EOB forms, regardless of their location or the number of occurrences across multiple pages. It is also said to be able to read data elements with varying formats, such as dates and currency amounts.

Accurate Machine Print Recognition Rates: The vendor states that the OCR (Optical Character Recognition) engine used in Optiform eobXL has demonstrated high recognition accuracy rates, reaching up to 99.98%. It is claimed to require minimal character correction, with less than 20 characters per 100,000 characters processed.

Data Conversion: According to the vendor, Optiform eobXL includes a utility that allows users to convert extracted data elements into a standard format, ensuring compatibility with other systems and processes.

Hierarchical Data Structure: The solution's underlying data structure, as claimed by the vendor, is designed to capture, organize, and validate data according to the basic structure of an EOB and the required data output format for patient billing systems. It includes records for claim header, claim transaction, claim transaction detail, and claim footer.

Automatic Identification and Grouping of Transactions: According to the vendor, Optiform eobXL can automatically identify and group transactions based on the appropriate output format. This feature is said to ensure that claim level transactions on EOBs that break across pages are kept together as a single transaction without manual intervention.

Automatic Validation of Suspect Characters and Missing Data Elements: The vendor claims that the processing solution provides an interface for reviewing and correcting characters with low accuracy rates. It also identifies when data elements are missing from a transaction, allowing users to review and address any missing information.

Payment Reconciliation: According to the vendor, when claim payments do not balance against the payment total, Optiform eobXL offers an automated mechanism to review payments and correct possible math errors, ensuring accurate payment reconciliation.

Missing Pages: The vendor states that Optiform eobXL allows missing pages to be re-integrated with batches in-process when they are obtained at a later date from the payer, facilitating a seamless processing workflow.