For managed care organizations (MCOs), ensuring accuracy of risk-adjusted revenue data while remaining compliant with encounter guidelines is a key priority. One MCO serving over 2 million members in the Southeast and Midwest needed to streamline their encounter operations—and they turned to Edifecs to help them do it.
In this case study, we outline how our Encounter Submissions solution helped the plan eliminate complex manual workflows and adapt more quickly to changing CMS guidelines while maintaining an acceptance rate over 99% for Medicare and Medicaid claims.
Ready to improve submission accuracy and ensure ongoing compliance? We can help. Get in touch with us to learn more.