Ensuring accuracy of risk-adjusted revenue data and remaining compliant with submissions-related encounter guidelines are common challenges for managed care plans. And if that’s not enough, managed care plans also have to navigate frequent changes to regulatory requirements, state-specific nuances, and the complexities of using multiple submission systems.
Edifecs Encounter Management is a best-in-class SaaS-based solution designed to help plans overcome these challenges. Our solution utilizes AI-enabled coding and analytics to break down encounter operations silos, support submission accuracy, and ensure compliance across all managed care lines of business.
Edifecs Encounter Submissions helps break down operational silos, improve submission accuracy, and ensure compliance across all lines of business.
The video introduces Eric, the VP of Claims and Counters at a managed care organization, who faces issues with unsubmitted encounter data causing incomplete payments. The outdated system can’t handle the growing complexity, leading to compliance risks and potential financial losses.
Eric needs a solution for accurate encounter submissions, compliance, and first pass rates. He requires a unified data view, robust error correction, flexibility for custom rules, and scalability.
Edifecs Encounter Management is presented as the solution, offering continuous compliance, cost reduction, improved risk scoring, error correction, customizable workflows, AI-enabled monitoring, and comprehensive data views. These features help Eric’s team recover payments and avoid financial disasters.
The video concludes with Eric relieved and confident, inviting viewers to learn more at edifecs.com.
Managing Multiple Vendors is a Headache. Edifecs is the Cure.
Find out how we can help you streamline your encounter submissions.
Maximize data quality and accuracy for more effective submission operations.
Ensure accurate payments for submitted encounters.
Enable automatic, ongoing compliance with CMS and state requirements.
