As a participant in the ACA Marketplace since its inception, a large North Carolina-based health plan had seen it all…the turbulent roll out, competitors coming and going (and then returning), and a resurgence driven by the current administration as well as the pandemic.
Blue Cross Blue Shield North Carolina (Blue Cross NC) and Edifecs present this informative webinar sharing important insights into the state of the ACA Marketplace and its current enrollment challenges.
Edifecs is the market-leader in data submission and we take a state-specific approach to encounter management. No more manual processes and workarounds. No more compliance issues. We deliver a fully-baked encounter management solution built for Michigan MCOs ensuring compliance and reduced manual effort through built-in workflows.
A 3-Part series giving information about Solving MSO Business Problems , Modernizing the EDI Front-End to Ensure Up-Front Data Compliance & Visibility and Using Best-in-Class Encounter Management to Drive Revenue Accuracy
It’s no secret managed care plans generate mountains of health data. Yet much of this data is stuck in disconnected siloes…both inside and outside the four walls of a plan. For today’s health plans, this is no longer acceptable. Regardless whether the need is to comply with new CMS mandates, enhance risk-adjusted revenue accuracy or both, disconnected data must become a thing of the past.
Edifecs, the market leader in encounter management, has developed an encounter submission module just for the state of Maryland. With the required formats, rules, companion guides, etc…already included, it’s encounter data submission made easy.
Self-service EDI integration with Edifecs Ramp Management reduces supplier integration costs and dramatically increases the number of suppliers onboarded each month. Edifecs Ramp Management delivers 60% reduction in FTEs required to onboard a supplier and 75% increase in suppliers added per month.
New York is implementing sweeping changes in how it collects encounter data from managed care plans (MCOs) and Medicare Advantage Plus (MAP) plans. In this webinar, Edifecs details how we ensure continuous New York managed care encounter submission compliance now and in the future.