Billing and InsurancePurpose
1.2. Enable automated extraction, classification, and assignment of EOB data to relevant patient accounts and claims for streamlined reconciliation and posting.
1.3. Facilitate real-time, automated notifications of EOB arrival and automate distribution of parsed EOB data to billing, collections, and reporting workflows.
1.4. Ensure automatable compliance with HIPAA and audit requirements by logging all automated EOB import actions and maintaining automated records of payer correspondence.
Trigger Conditions
2.2. Automator triggers upon receipt of PDF, 835, or standardized EDI file formats.
2.3. Scheduled automating (e.g., hourly or nightly) or event-driven automating based on file appearance.
2.4. Manual override trigger via web interface or management dashboard for urgent automating or reprocessing.
Platform Variants
- Function: Automate cloud flow; trigger: "When a new email arrives (V3)"; action: "Parse file", then "Create item" in Practice Management app.
3.2. Zapier
- Function: Automate Zap with Gmail/Outlook trigger; Action: "Text Parser" + "Google Sheets" for EOB details, feeding billing app by automating API call.
3.3. Integromat (Make)
- Scenario: Automated HTTP Webhook trigger + Email parser; action: "Parse EOB PDF/EDI" + "HTTP Action" to billing system API.
3.4. UiPath
- Activity: Automate "MailMessage Trigger" + "Read PDF Text/EDI parsing" + "Insert Row" in accounting software.
3.5. Boomi
- Process: Automated Mail Listener + EDI 835 Parser shape; connector: Billing/ERP via HTTP Client.
3.6. MuleSoft
- Flow: Automated Scheduler or Email connector; "EDI to JSON Transformer" + Database insert API.
3.7. AWS Lambda
- Function: Automate S3 event trigger on EOB upload; Lambda parses EDI, sends to RDS or billing app.
3.8. Azure Logic Apps
- Logic App: "When a file is added" (Blob Storage trigger); "Parse file" + "Insert into Table Storage or SQL Server".
3.9. Google Cloud Functions
- Function: Automate Cloud Storage trigger on file upload; Code parses EOB, automates Pub/Sub message to downstream apps.
3.10. Dell Boomi
- Mail/FTP Listener; EDI to XML process; automates update to practice management CRM endpoint.
3.11. Workato
- Recipe: Automated "New Email" trigger; "Parse Attachment" + "Update Database/Practice Mgmt App" action.
3.12. Smartsheet
- Automation: "Email Attachment Received" in sheet row; "Document Parser" + "Cell Update."
3.13. Salesforce Flow
- Process Builder: Automated EOB file upload trigger; EDI parsing Apex Action; record update in Billing Object.
3.14. Docparser
- Rule: Automatedly parse PDFs; webhook push to billing system endpoint.
3.15. HubSpot
- Workflow: New engagement logged; workflow automates notification/assignment to claims specialist.
3.16. AirSlate
- Bot: Email monitor + EOB data extraction + automated data posting to ERP/billing system.
3.17. Tray.io
- Trigger: Email or SFTP file received; JSON conversion; automated API call to financial system.
3.18. Pabbly Connect
- Workflow: Email trigger + PDF/EDI parser; push to practice app using HTTP module.
3.19. Jitterbit Harmony
- Event: Automated file detected on FTP; operation automates parsing and updates billing database.
3.20. SFTP Watcher (Custom)
- Service: Monitors SFTP; automates download and parses EOBs; pushes via REST API.
Benefits
4.2. Minimizes posting errors by automating data extraction.
4.3. Accelerates claim reconciliation, automating posting and secondary billing readiness.
4.4. Ensures timely availability of EOB data with automated notification and posting.
4.5. Automates audit trails and improves regulatory compliance in EOB management.
4.6. Enables scaling of billing operations for high-volume, multi-payer environments via automation.
4.7. Improves cash flow with faster, automated claim updates and secondary payer billing.
4.8. Automating repetitive EOB workflows empowers billing teams to focus on higher-level claim exceptions.