James A. Carruthers, Managing partner, OmniView Medical Solutions
Invented in the early 1970s, the 835/837 Electronic Remittance Advice (ERA) transaction set was the format established by the American National Standards Institute (ANSI) to meet HIPAA requirements for the electronic submission of healthcare claim information. In the purview of medical practice management, the lack of clarity in reading these files sticks out like a sore thumb. This is only made worse by the fact that smaller healthcare providers are at a loss for resources to facilitate this action, and it is to serve this particular demand that New Jersey based OmniView Medical Solutions, provides its revolutionary 835/837 Solution product, the industry’s first all-purpose universal Medical ERA reader. As OmniView’s managing partner, James A. Carruthers says, “What our product is designed to do, is create a simple solution for a really complex problem.”
OmniView has created a 100 percent HIPAA compliant universal reader, where EOB files can be loaded into a single application by either smaller private practices or hospitals. It collects all the data in one place for easy viewing, and analyzes it, to spot problems and correct them. The output is delivered in a simple and viewable format and all the resultant information is exported to excel, or any common linear format. The 835/837 Solution is an independent software program that can be downloaded over the internet for which the users need only pay a monthly licensing fee. The software only needs to be occasionally updated and operates concurrently with any application the provider is running already.
What our product is designed to do, is create a simple solution for a really complex problem
The watchdog timer is a unique facet of this application, and it regularly checks files, across a specific location on the computer for incoming 835 data, and depending on the traffic, the timer can be set to check that folder constantly for new incoming 835s. The software will process those files automatically as they come in, and export them to excel, and so the tool takes the complexity out of the when and what of real-time processing. Post-processing, the excel files may be reviewed and connected to their respective fields so that the output information can be derived from it. For firms with very complex billing systems, it can arrange the data in the proper order so that it can be easily backended into other systems.
Carruthers says that the 835 form itself is where the rubber hits the road as far as payment goes. Seeing as it is the case with any advanced ERA software, it boils down to a single point, either for larger healthcare providers or private practitioners, the billing must be consistent and without discrepancy. Within the application, one can load as many 835 files at one time, and run a scan through it to see all the payment information line up and pop onto the screen.
For OmniView, the goal in the future is to make the product simpler and easier to use and to give information even to somebody who is not in the healthcare arena, at the click of a button. OmniView also sees itself expanding into the industry based on customer requests and actively interacting with them. The company is looking for the next niche, something that the clients want, but doesn’t yet exist. It is Carruthers’ firm belief that the OmniView team can accomplish whatever they put their minds to, and no matter what the next horizon will be the demand for a robust solution will come from the customer.