• Demo
• Log In
• Support

MediStreams News

• News
• Demo
• Security

Why Paper Correspondence and EOB Conversion Are Still the Biggest Revenue Cycle Bottlenecks

In an era of digital transformation, it’s easy to assume that paper correspondence in healthcare payments is a legacy issue that has gone away. Yet for revenue cycle teams, the reality is stark: paper-based explanation of benefits (EOBs) and correspondence continue to act as one of the largest bottlenecks in achieving visibility, control, and operational efficiency.

According to the 2024 CAQH Index Report, the U.S. healthcare industry has a $20 billion annual opportunity to reduce administrative waste by shifting to fully electronic administrative transactions. And as CAQH’s Insight Report: Administrative Transaction Costs by Provider Specialty Index notes, paper and partially-electronic workflows remain barriers in key transactions such as remittance advice.

These insights tie directly into the specific challenge faced by many provider organizations: stacks of remittance and payment correspondence arriving in paper form (or as image files), delivered via lockbox or mail, requiring manual intake, sorting, and indexing. Without automated indexing of correspondence, the backlog builds, data remains trapped, and revenue cycle visibility is impaired.

The Persistent Challenge of Paper-Based Correspondence

Consider what happens when paper EOBs arrive:

• They are received via mail or lockbox, often as physical documents or static images.

• They must be opened, sorted, handed off, indexed (for payer, patient, claim, date, type of correspondence).

• If the correspondence includes multiple payer documents, check attachments, explanation letters, or obvious anomalies, each may require follow-up.

• Until indexed and entered into a digital workflow, the document is essentially “offline” and invisible to reporting and automation.

In the meantime, other digital remittance channels push forward via electronic remittance advice (ERAs) and ACH payments, but the correspondence backlog remains a drag. Another CAQH report found that even as automation adoption grows, the administrative burden continues due to incomplete end-to-end digitization of all transaction types.

Why Generic OCR or Lockbox Scanners Aren’t Enough

The barrier isn’t simply about scanning documents. It’s about indexing them appropriately so that the correspondence becomes actionable. Many lockbox capture solutions generate image files, but without the intelligence to classify the type of document, extract key metadata (payer name, patient account, date of service, payment/adjustment amounts, claim numbers), and route to the correct workflow queue, the burden remains.
Some of the typical gaps include:

• Payer correspondence that doesn’t follow a standard layout, especially secondary payers or supplemental benefit payers.

• Multi-document envelopes being scanned as a single image, requiring human intervention to break apart.

• No consistent taxonomy for payer letters, attorney notices, bankruptcy letters, etc., meaning staff must manually route documents to the right team.

• Lack of integration with provider ERP/RCM systems for correspondence-tracking, escalation, and reporting.

The True Cost of Unindexed Correspondence

While many studies focus on costs of paper billing or check payments, indexing correspondence represents a hidden drag on operations. Here are some of the cost implications:

• Visibility lag: Until correspondence is indexed, it isn’t part of the digital queue. That means delays in follow-up, unanswered payer letters, lost opportunities for appeal, and poor reporting on month-end close.

• Labor burden: Staff hours are spent sorting, routing, and handling exceptions rather than higher-value tasks. Even though post-posting labor is not the focus here, the indexing work still consumes meaningful FTE time.

• Operational risk: When correspondence sits unindexed, the risk of oversight (denials unworked, check mismatches, uncashed checks) increases.

• Reporting blackout: Without indexing and digital capture, organizations lack the ability to analyze trends in payer correspondence, identify repeat issues by payer or patient, and build workflows to improve performance over time.

The CAQH Index underscores how incomplete automation across administrative workflows continues to add cost: the industry avoided $222 billion in administrative spending, but much of that still ties to transactions such as remittance advice, coordination of benefits, and other payer–provider interactions.

How Intelligence in Correspondence Indexing Drives Impact

For healthcare organizations ready to break through the bottleneck, indexed correspondence offers three major payoff areas:

1. Faster Work Queues – When documents are indexed and tagged by payer type, date, patient, and claim, the dispatch to appropriate team or workflow happens automatically. That leads to faster resolution of payer letters, fewer handoffs and less delay in reconciliation.

2. Better Insight – Indexed correspondence becomes data. You can monitor volume by payer, by correspondence type, by time in queue, and identify payer-specific patterns of errors or requests. That allows targeted process improvement, payer negotiation and exception-tracking.

3. Reduced Backlog Risk – With automation to ingest and classify correspondence (paper or image), organizations move what was once a static pile of mail into the digital workflow. That prevents the build-up of unprocessed mail, reduces the risk of “lost” documents, and improves revenue cycle transparency.

A Call to Action for Revenue Cycle Leaders

In 2025, it’s no longer sufficient to focus only on claims submission or patient billing. Revenue cycle excellence requires end-to-end visibility of payer correspondence, especially the paper or non-standard remittance streams that so often slip through the cracks.

If your team is still sorting envelopes, waiting for image files, or working off spreadsheet trackers to manage payer correspondence, it’s time to invest in a solution that automates indexing and routing, without disrupting your existing bank lockbox or payer arrangements.

At MediStreams, our Correspondence Indexing and EOB Conversion solutions eliminate the paper bottleneck by transforming scanned mail, PDFs, and lockbox output into structured, searchable, and actionable data, without requiring you to change your bank or disrupt existing workflows.

Here’s how it works:

• Automated Capture and Classification – MediStreams ingests correspondence from multiple sources — including lockboxes, payer portals, and secure email — and uses advanced AI-powered OCR and NLP to identify payer, patient, and document type with 99% accuracy.

• Smart Routing and Categorization – Documents are automatically indexed into 30+ correspondence categories, from denials and audits to credentialing notices and fee schedule updates. Each item is automatically routed to the appropriate team or department, ensuring nothing gets lost or delayed.

• Searchable Archive and Compliance – Every indexed document is stored in a secure, 10-year digital archive that includes the original scanned image and full audit trail. Staff can instantly search by payer, patient, date, or correspondence type — eliminating the need for manual retrieval and paper storage.

• Seamless Integration – Indexed correspondence is delivered directly into core healthcare systems such as Epic, Cerner, and OnBase, as well as practice management or RCM platforms. This provides a single source of truth for all correspondence, accelerating resolution and improving transparency.

Unlike traditional lockbox or document-scanning vendors that stop at image delivery, MediStreams goes further, transforming unstructured correspondence into actionable data that flows seamlessly into your existing systems. The result is faster response times, reduced administrative workload, and complete visibility across your revenue cycle.

By converting correspondence chaos into clarity, MediStreams helps healthcare organizations capture every dollar, respond faster, and reconcile with confidence.

Request a Demo to see how Correspondence Index can unlock visibility, cut inbox volume, and turn payer mail into actionable data.

Back to MediStreams News