Jopari eBill®

• Workers’ Compensation
• Auto Medical
• Commercial and Government

Jopari’s eBill service delivers all-encompassing State jurisdictional and Federal EDI transactional (ASC X12N) compliant electronic medical bill and Attachment processing to Property & Casualty Payers (Workers’ Compensation, Auto Medical and Commercial & Government and other coverage areas) through a hosted transaction gateway, in addition to access to our continually expanding Payer-Provider connectivity network.

With Jopari eBill, electronic medical bills and Attachments are received from Providers, billing services, clearinghouses, and other sources.  They undergo indexing, validation for required data, are normalized and delivered to the Payer in their required specified formats, ready for medical bill processing.

Integration with Provider Systems

Jopari eBill is integrated with many leading bill review and claims management systems, therefore is capable of delivering bills in the format the Payer’s existing applications expect – a critical step in minimizing implementation impact on Jopari client IT resources.

For Provider trading partners, Payer furnished bill cycle automation yields dramatic reductions in A/R cycles, expedites remittance receipt matched to payments, streamlines reconciliation efforts and simplifies access to bill and payment status.  No more phone tag, which can burn up 25% or more of claim staff time.

Jopari eBill®At-a-Glance

Expense Reduction

Jopari eBill generates direct savings in administrative expenses in a multiple ways: improving bill data input accuracy; eliminating incomplete bills, missing Attachments and duplicate bill submissions; decreasing bill/payment status call volumes by 80% by means of Provider “self-service” data tracking and auditing capability.

Jopari network Payers gain market-wide eBill compliance with evolving state and federal regulations, coupled with continuously visible, controllable medical bill processing workflow that yields sustainable improvements in staff productivity.  Reductions in mailroom manual workload of 70%+ are possible by decreasing or eliminating manual and paper intensive bill and Attachment workflow.

Transaction Types:

  • 837 / 275 (Bill and Attachment)
    • TA1 999/997 / 824 (Acknowledgments)
    • 276 / 277   (Bill Status Inquiry / Response)
    • 835   (Remittance Advice)
    • Other mutually agreeable formats (as needed)

Automated Scrubbing

  • Interchange Level Validation
    • ASC X12 Validation
    • Clean Bill / Jurisdictional Edits / Attachment Rules
    • Payer-specific Edits and Rules
  • The Payer receives only “Clean Bills”

Converts Bills to Payer’s Specified Format

  • Payer does not need to Modify Existing Applications
  • Offers support for Non-Standard EDI Bill Formats
  • Images of HCFA / UB / NCPDP/ Other State Forms are rendered from Bill Data
  • Payer Rules Dependent (Optional Feature)
  • Attachment files can be TIF, PDF, HL7 or other formats

Management of Provider Relations

  • EDI Trading Partner Agreement generation, execution, and management
    • Provider recruitment, servicing and support

Enhanced Document Management

  • Inbound Images of Bills / Attachments (Payer / configuration specific meta data / image Indexing
  • Technology based modernization of claims operations