Resources

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.

Accelerate and sustain value-based program success

Accelerate and sustain value-based program success

Mitigate risk while safeguarding revenue

CMS-regulated payers required to implement Patient Access APIs to provide access to claims, encounter, clinical, and formulary/preferred drug list data

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

Answering common questions about the final rule and its implications on healthcare organizations.

A study of the healthcare market's response to the proposed interoperability rule and what the final rule means for organizations.

Understanding the requirements of the final rule and the implications it has for healthcare organizations.

The Three Points which can help you achieve the Encounter Platform Selection Success

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.

Leverage AI and ML to Enhance Encounter Data Quality and Revenue Integrity

FAQ's Related to Edifecs Enrollment Management Solution

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.

NAMM California works as a delegated model, contracting with health plans to manage risk associated with delivering healthcare services.

The heat is on. We’ve got the experience to “heat proof” your revenue integrity!

Streamline the Medicare Advantage encounter management lifecycle for both RAPS and EDPS submissions

How health plans can improve enrollment operations through managed services

A complete encounter lifecycle management solution for managed Medicaid health plans

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.