State Medicaid Agencies continue to increase the weight on encounter data in the Medicaid rate setting process and in risk adjustment payments to health plans. Having a successful encounter data submission process has become critical to receiving accurate and timely revenue. Do you know how your plan’s encounter data may be impacting your revenue?
Through firsthand client experience, we know accurate encounter data submissions are crucial for the development of actuarially sound rates and long-term risk scores. It is not uncommon for health plans to purchase an encounter submissions software solution thinking that technology alone will be the answer. Unlike most vendors’ solutions, Cirdan views encounter data submissions as an integral extension of the claims processing cycle. Our solution keeps your submission data in sync with your claims, enrollment, and provider systems.
- Error rates significantly below other health plans in the same state
- Compliance risks mitigated
- Root cause identification and resolution
Our comprehensive Encounter Data offering:
- Business process assessment and consulting
- Cirdan web tool for submission management & audit
- Full-service encounter submissions