Medicare Encounter Data Submissions and Consulting
Cirdan views accurate encounter data submissions as critical to a successful Medicare program and an integral extension of the claims processing cycle. Our solution assures risk score accuracy and reduces audit risk by keeping your submission data in sync with your claims, enrollment, and provider systems.
Risk scores calculated using encounter data are significantly lower than RAPS based risk scores for many plans. CMS continues to place more weight on Encounter Data to determine risk adjusted payments. Is your plan prepared for the increased reliance on EDS data?
Cirdan CMS Client Experience:
- Encounter claim rejection rate < 1.0%, national average 3.0% - 6.0%
- Encounter line rejection rate < 1.0%, national average 4.0% - 7.0%
- RAPS and Encounter Data risk score consistency
Our Comprehensive Encounter Data Offering:
- Business process assessment, audit and consulting
- Cirdan web-based tool for submission management & error resolution
- Full-service client submissions