Identify errors in your Encounter Data and prioritize
rejections by HCC and financial impact
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ENCOUNTER DATA ERROR
RESOLUTION AND FINANCIAL PLANNING

Ensure accurate, complete and compliant encounter submissions with a one-stop tool for error management, reconciliation, and financial analytics

Streamline reconciliation of RAPS with Encounter Data, identifying missing HCCs, and inaccuracies in either format

Compare RAPS vs MAO-002 vs MAO-004 to ensure acceptance and proper calculation of risk scores and payment by CMS

Automate the receiving and processing of CMS responses to claim transactions – TA1, 999, and 277CA

Use it as a Cloud based SaaS application or fully outsourced submission service

Manage RAPS and EDPS submissions, and matching and processing of supplemental data

Financial Projections

Be confident in your sweeps payment predictions with accurate estimates for both RAPS and EDPS submissions.

View final payments, average monthly PMPM, revenue forcasts, and more.

Accurately assess that last push for chart review, the re-submission of EDPS data, and the deletes of a submission mistake to make sure that you have accurate cash flow projections.

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FEATURES

FILE
SUBMISSIONS
01

Benefit from parallel processing, submit one file for both RAPS and EDPS formats

ENCOUNTER
STATUS
02

View the status of submitted encounters, error types, and categories. Ensure submission accuracy by gaining visibility into error rejection rate for timely resolution

ERROR
SOLUTION
03

Identify errors before submission, prioritize errors with the highest financial impact, and resolve them - all in one single tool

REVENUE
PROJECTIONS
04

Accurately project mid-year and final sweep payments for both RAPS and EDPS submissions.

Retrospective sweep payments can account for 5-10% of a plan's total revenue in Medicare.

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BENEFITS

Highly configurable error resolution and financial analytics

Simple interface enables you to manage and resolve errors by category and type all in one place
Obtain visibility into summary level dashboards showing total financial robust segmenting capabilities allow you to identify and prioritize errors with highest HCC impact
Increase accuracy with a front-end automated data quality management-editing, cleansing, transformation, and de-duping
Gain greater transparency and speed in operations management through ready-to-use ad hoc reports
Access RAPS filtering of CMS-EDPS results with filter criteria that is easily configured by payer
Access real-time tracking of Encounter risk adjustment data submissions and status