An encounter data analytics platform for payers that want flexibility to handle systematic processing of error management, interpretation, and reconciliation to meet revenue goals.
Automate and validate inbound file and counterparty processing to reconcile data that requires significant transformation to meet complex and varying file requirements for different claim types.
Manage duplicate claim data by systematically replacing historical, identical claim data, and actively processing the current version to minimize multiple submissions of the same claim.
Analyze error mix and processing results to prioritize errors by using multiple filter and group-by options to help meet rigid error correction deadlines.
Minimize interruptions and rework by leveraging expert custom analytics support from our proactive, throughput focused Program Management team that helps you navigate ambiguous guidelines.
Facilitate and streamline the transition from Risk Adjustment Payment System (RAPS) processes for Medicare Advantage risk adjustment to the Encounter Data Processing System (EDPS).
Reduce inaccurate submissions through our pre-submission gate validation analytics and insights to identify errors, directing resolution through clear and logical gates.