The billing office · CapturePoint 6

EOBs, prior auths and credentialing paper, read on the billing office PC.

For billing managers, payment posters and the person who keeps provider files current. CapturePoint 6 sets up a job from a folder of your own payer and patient paper. Here is what it does with three kinds of it, and what you add.

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See the three documents

Free trial on first launch. No form. Pages are read on your PC.

Six fields it reads on an EOB. Example data.

Set up the job before you open the mail.

1
Take the 2-minute tour
The welcome screen offers a short tour: you do the real steps on five sample accounts payable documents before you scan anything real.
2
Bring in a folder of your own
Point it at a folder of EOBs, remits, denials, appeals and referrals you already have, and it sets up the document types and fields from them.
3
Put your own stack through
Scan this morning’s payer mail with your own TWAIN scanner, or add PDF and TIFF files your fax service saved.

Your stack being read on the PC: prepare, read, split, understand, finish, even on a soft scan.

Three documents, three desks, honestly told.

What the job does with each one from the start, and what you add to make it yours.

Payment posting

Explanation of Benefits

From the start: Set up from a folder of your own EOBs, with fields such as statement reference, statement date, member ID, member, plan name and patient responsibility. Remittance advice gets its own type with the payer, payment reference, date, payee and NPI, and payment amount.
What you add: Nothing to start. As you confirm your own payers’ layouts, the job learns them.
Where it ends up: Filed by member and statement date, with a data file of every value for your posting team.

Front end and scheduling

Prior authorization determination

From the start: Recognized as its own type, read for fields such as the reference number and the member ID.
What you add: Add the fields your schedulers ask about, such as the decision, the service and the dates it covers. Use Add field on the review screen; after a few confirmations the job reads them on its own.
Where it ends up: Filed under the member with the reference number in the name, so the approval is found when the claim is questioned.

Provider enrollment

Credentialing paperwork

From the start: Not in a job set up from payer and patient paper alone.
What you add: Add your own types from the review screen, such as state license, DEA registration, board certification and malpractice certificate, each with the provider, number and expiration date. CapturePoint 6 also suggests new types when it sees paper it does not know, and shows its evidence.
Where it ends up: Filed per provider, one folder each, ready for the next payer application or recredentialing cycle.

The sheets that are not documents stay out of the way.

Billing offices scan in batches with a separator sheet on top, and much of the payer paper arrives behind a fax cover. Scanned as one stack, those sheets easily end up as page one of the EOB behind them.

Include a few of each in the folder you set the job up from, and it learns both. Your separator is read as a Scan Batch Separator, with the queue, the organization and who prepared the batch. A fax cover is read as a Facsimile Transmittal, with its request ID, date and patient. Each is kept as its own small record, and the denial or approval behind it starts on its own first page.

You decide how sure it has to be before a page skips you.

A threshold per field

Patient responsibility can need more certainty than plan name. Before you save, it shows how many documents in the job would go through without review and how many would wait.

A reason on everything that waits

Each waiting document says why in plain words. Look at the page beside its fields, fix what is wrong, and press Ctrl+Enter.

Fewer waiting every week

Every confirmation teaches the job, and it re-checks the stack as you go. After steady use, most documents need no review, and the ones that do are the ones worth a look.

With Content Central

A license that expires should not be news.

Payers commonly recredential providers every few years and expect current licenses, DEA registrations and malpractice certificates in between. When credentialing documents go to Content Central with their expiration dates as fields, one workflow rule can email the credentialing coordinator 30 days before any of them runs out.

The same library holds the payer paper, so a denial, the appeal that answered it and the remittance that finally paid sit on one account, found with one search.

The rule, as you would set it

When: A credentialing document's expiration date is 30 days away
Then: Email the credentialing coordinator, with a link to the document
Checked: On a schedule you set, every day if you like

The same recipe in the help library

Plain answers for the billing manager.

Does it post payments into our billing system?: No. It reads and files. Every document leaves with a searchable PDF and a data file holding each value it read, which your team or IT can bring into other systems.
Will it read every payer’s EOBs, not just the ones we set it up with?: Yes, after a few confirmations. Each confirmation teaches the job a layout, and it re-checks the documents still waiting, so a correction on one payer’s EOB can clear the rest of that payer’s stack.
Can it check a member ID against our patient list?: Yes. Load a list from a file, such as an export of your patients, and use it to check or fill a field. The list stays on the PC.

Put Monday's payer mail through CapturePoint 6.

Install CapturePoint 6 on the billing office PC. The free trial starts the first time you open it. We sign HIPAA Business Associate Agreements.