Resources

The DNA of CMS Encounter Submission Success
What’s in the DNA of your encounter management system? Does it have what it takes to drive RAPS/EDPS submission/reconciliation accuracy? Ensure compliance with evolving CMS requirements? If not, your plan can lose risk-adjusted revenue and face penalties. Overcoming these (and other) challenges requires a re-wiring of your encounter operations DNA. This process starts with selecting a best-in-class encounter management platform.
Webinar

Interoperability Solution with FHIR
A simplified approach to meeting compliance with the CMS Interoperability & Patient Access Final Rule and the ONC 21st Century CURES Act Final Rule
Solution Brief

Encounter Platform Selection Success The Definitive Guide
Improving risk-adjusted revenue accuracy, closing compliance gaps and reducing encounter operations costs requires the selection of the right encounter submission platform. Making this selection begins with health plan best practices on how to define and use a comprehensive set of encounter platform evaluation criteria.
Webinar

Smart Encounters
Leverage AI and ML to Enhance Encounter Data Quality and Revenue Integrity
Data Sheet

Optimized Medicaid ACO Enrollment in Massachusetts
Edifecs comprehensive enrollment management solution are built-in validations and integrated workflow processes to increase data integrity by enabling visibility and validation upfront in the enrollment process.
Data Sheet

One Enrollment Hub to Manage All Your Channels
With dynamically changing regulations and legislation around coverage, subsidies, and penalties, health plans must optimize their enrollment operations to be able to respond quickly to such changes, and gain a competitive edge over those who are underprepared.
Solution Brief