Lido extracts data from CMS-1500 and UB-04 claim forms, validates required fields, and flags errors before submission.
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Reconciling billed vs. allowed vs. paid across hundreds of claims is the billing bottleneck. Lido automates it.
CMS-1500 and UB-04 claim copies arrive as PDFs. EOBs arrive as scanned mail or 835 ERA files. Lido processes both in the same workflow so reconciliation is available when each pair is complete.
From CMS-1500: boxes 1-33 including patient info, insurance ID, NPI, CPT codes, ICD-10 codes, modifiers, units, and charges. From UB-04: revenue codes, procedure codes, HCPCS codes, diagnosis codes, and itemized charges. All fields extracted from electronic or scanned paper claims.
CPT, HCPCS, and ICD-10 codes validated against standard formats. NPI validated against 10-digit format. Date-of-service fields checked for logical consistency. Validation errors are flagged before reconciliation.
Lido matches claims to EOBs using claim number, patient ID, and date of service. Each line shows: billed, allowed, payer payment, patient responsibility, adjustment, denial code, and reason code. Potential underpayments are flagged.
Denied claims are classified by denial reason (CO-45, PR-1, CO-16) and prioritized by balance. Underpayments where the payer paid below contracted rate are flagged. Your billing team gets a prioritized work queue, not a pile of EOB PDFs.
Upload a batch and get structured output in minutes.
Standard professional claim form. All 33 boxes extracted including diagnosis pointers and service line charges.
Standard institutional claim form for hospitals and facilities. Revenue codes, procedure codes, and itemized charges extracted.
Paper EOBs from commercial payers and Medicare/Medicaid. Billed, allowed, paid amounts plus denial codes extracted.
835 ERA files processed alongside PDF EOBs in the same reconciliation workflow with the same output schema.
Claims submitted to secondary or COB payers after primary adjudication, with primary EOB data incorporated.
Corrected claims (frequency code 7) and resubmissions. Lido tracks version history and links to the original denial.
| Feature | Lido | Manual data entry |
|---|---|---|
| Extract all fields from CMS-1500 and UB-04 claim forms automatically | ✓ | ✗ |
| Match claims to EOBs and ERAs by claim number and patient | ✓ | ✗ |
| Classify denial codes and flag underpayments vs. contracted rates | ✓ | ✗ |
| Validate CPT, ICD-10, and NPI formats before reconciliation | ✓ | ✗ |
| HIPAA-compliant. PHI and claim data deleted within 24 hours | ✓ | ✗ |
| Read the EOB and post each payment and adjustment manually | ✗ | ✓ |
Reconcile claims against EOBs automatically and give your billing team a prioritized exception queue.
A 15-physician multispecialty practice submits 600 claims per week across 8 payer contracts. EOBs arrive across 4 days from different payers. Lido reconciles each claim against the corresponding EOB, flags 34 underpayments against contracted rates, and identifies 12 denials worth appealing, before the billing manager's morning review.
A 200-bed community hospital submits UB-04 claims for inpatient, outpatient, and observation encounters. Revenue code-level reconciliation against 835 ERAs is performed automatically, with DRG payment variances and outlier payments flagged for the hospital billing manager.
A billing company managing claims for 30 physician practices processes claims and EOBs from a centralized billing platform. Lido routes each reconciled claim to the correct practice client and generates per-practice denial and underpayment reports for the weekly billing review.
An infusion center submits high-cost drug claims for biologic therapies. Each claim cycle starts with a prior auth, progresses through claim submission, and ends with EOB reconciliation. Lido tracks the full cycle, from prior auth approval through final payment, and flags claims where payment does not match the auth-approved amount.
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