Not All RCM Companies
Are Created Equal

Technology Enabled Revenue Cycle Management

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Our collections improve every month because as a team, we’re all doing better.

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Encoda’s Revenue Assistance ProgramTM, powered by Encoda BackOffice and Encoda Maestro Analytics delivers shorter payment cycles, higher collection rates, and reduced operating expenses to your medical business.

Revenue Assistance ProgramTM

We know there are multiple medical billing companies in America, employing quality people, that perform well for their clients.  However, none of these companies have the same revenue cycle management technology as Encoda.

Encoda is a technology enabled services company that has developed patented revenue cycle management tools over a 30-year time period that enhance the billing cycle.  This technology is at the heart of our services and what separates us from all other RCM companies.

The industry has gone past the point where a smart, experienced employee can make all the difference. In today’s world of complex reimbursement you must have both the right people and the technology to maximize revenue and timely payments.

Encoda’s Revenue Assistance ProgramTM eliminates the pain and complexities involved with medical billing and ensures that your insurance reimbursement is maximized for the services that you deliver to your patients.

Points of Difference

Encoda believes in 100% transparency and as a result, provides our RCM clients with access to Maestro Analytics, as a part of our service, so you can see how our team is billing and collecting on your behalf. Maestro Analytics provides insight into the billing cycle by combining data from the PM system and payers in one, easy to use dashboard reporting system, accessible 24 x 7 via mobile phone or PC.

But it doesn’t stop there.

Encoda’s technology enabled RCM Services are powered by Encoda BackOffice which is our patented, cloud-based, denial management platform that complements your existing PM application and provides our billing and collections staff with an efficient workflow tool to collect more of the money you’ve earned. Encoda BackOffice vastly improves the processes needed to effectively collect insurance reimbursement and improve revenue cycle performance.

As a result, Encoda’s revenue cycle management services deliver shorter payment cycles, higher collection rates, and reduced operating expenses to your practice.

Reduced Denials

Our revenue assistance team reviews each and every claim using our robust database of payer and specialty specific claim edits:

  • LCD, NCD, MUE, NCCI edits
  • Historical edits including global periods, bundling, and frequency counts
  • Claim structure edits
  • Client specific edits

Claim Routing Logic

Encoda’s revenue assistance team also utilizes customized pre-and post adjudication rules based on advanced business logic, which is part of Encoda BackOffice, to immediately serve up questionable claims for our RCM associates to review and rework, so we can better manage outbound claims and inbound remittances.

Automating a portion of the claims management process allows our billing team to focus on working those claims and denials that need attention.

Monitor. Measure. Manage.
Encoda Maestro Analytics

Encoda clients get 24/7 access to Encoda Maestro Analytics, our comprehensive dashboard and analytics platform, accessible via desktop PC or mobile device. Maestro Analytics provides you with real-time insight into our RCM team’s performance with your medical billing. We believe in providing transparency and insight into the billing process and we want our clients to know how our team is performing on your behalf.

Some of the key metrics that are tracked by Maestro Analytics include:

  • Aging report by dollars and percentages with month to month trending
  • Charge posting delay and billing delay by procedure grouping
  • Trending of charges, payments, adjustments, refunds & gross collection %
  • Claim note audits
  • Claim work queue backlog
  • CPT analysis and payer mix
  • Work queue closing velocity

Revenue Assistance ProgramTM Services

Clients can enroll in one or more of Encoda’s revenue assistance services listed below:

  • Claim scrubbing and submission
  • Pre-adjudication claims rejection follow-up
  • Post-adjudication claims denial follow-up
  • Payer no-response claims follow-up
  • Insurance payment posting
  • Patient credit reconciliation
  • Patient billing and statement inquiry
  • Patient payment posting
  • Key performance indicator reporting
  • Central billing office oversight

Revenue-CPR Assessment

Want insight into your billing and collections performance or to identify possible revenue leak? Maybe your current billing team is doing a good job but could do better with just a few tweaks?

Encoda’s Revenue-CPR assessment seeks to uncover and identify potential opportunities for your practice to collect more money by identifying and recapturing lost revenue. Our certified coders and data analysts use comprehensive metrics and financial analysis to discover practice revenue leak.

The final report presented to you reveals opportunity for recovery and outlines measures your practice can take to prevent future revenue leak.

Sign up now for your Revenue-CPR assessment.

Raving Fans

What Our Clients Say

“Encoda provided true scalability to our billing operations.  We were seeking a ‘rules engine’ to automate the many manual performed repetitive keystrokes typical in most billing settings.  As a result of Encoda BackOffice, our system is now ‘smart’; automating the mundane and freeing up our staff to spend time only on issues which truly require judgment.

We support 30 providers with only 3 FTE employees handling billing, posting and follow-up.  Encoda BackOffice has been able to do everything they claimed it would do – and that’s not something I can say for most other software I’ve ever implemented!”

Practice Administrator
Obstetrics & Gynecology Practice - Arizona

“We’ve been using Encoda BackOffice for 90 days. BackOffice had an immediate impact on our billing dept.  We had 3 A/R employees and we’re now down to 2.  We had 2 payment posters and we’re down to 1.

There were lots of BackOffice rules that we implemented and it has helped our claims go out cleaner and has streamlined our posting. The Encoda support team has been awesome.  They call us to let us know we’ve got an issue with a claim before my team even sees it.  I’m sure there is more we need to learn but what we have experienced so far has been nothing but greatness!”

Business Manager
10 Provider Rheumatology Practice - Colorado

“We have been using Encoda BackOffice since May and love it! Encoda has been a tremendous help to our billing and collection efforts.  Prior to Encoda, we were always behind in posting payments and now payments are posted immediately, and our staff can focus on A/R follow up.  The integration with GE CPS is fantastic!

Money that previously would have been lost is no longer a problem.  Our coders are now involved in fixing their own coding errors based on the Encoda BackOffice scrub rules.  The claim is fixed by the coder and then is immediately set for re-bill. Just one touch! Encoda has us set up to file directly with our major payers, meaning no clearinghouse! That in itself makes a big difference in what we can do!  With Encoda, we have completely revamped our billing processes.”

Business Office Manager
Rheumatology Practice - Texas

“We purchased the Greenway PrimeSUITE EMR because Encoda BackOffice is fully integrated with it.  We bill for 20+ providers, and have re-engineered our central billing office around the Encoda platform. BackOffice has completely revolutionized how we go about claim submission, payment posting, and claim follow-up.

Patient copay reallocations and payer recoupments are all handled automatically by the Encoda BackOffice platform.”

Chief Operations Officer
Pain Management Group - Delaware

“We were really at the end of our rope. Whether it was billing or running reports, everything of any value we did in our existing billing software and clearinghouse involved an agonizing process. But thanks to Encoda BackOffice, our productivity has skyrocketed! Today we bill for more than 100 providers with a staff of just 8 employees.

The Encoda BackOffice system bolts on to our existing PrimeSUITE billing software.  Additionally, Encoda has absolutely the best support we have ever had. When we need them they are always there for us.  I know this sounds like an ad, but it’s the truth. Thank you, thank you, Encoda.”

Director of Revenue Cycle Management
110 Provider Intensivist Billing Company - Pennsylvania

“We have been enrolled in the Encoda Revenue Assistance Program for over a year now. Our physician partners are thrilled with the results.  While our charges are up 9% year over year, our insurance receipts are up 26%!  Having our staff focused on charge entry and coding, while Encoda’s expert team is focused on claim submission and follow up has resulted in a winning combination. Additionally, Encoda routinely provides me with meaningful reports for the physician partner meetings.  Encoda has been a reliable and trusted partner in every way.”

Chief Executive Officer
13 Provider Obstetrics & Gynecology Practice - Indiana

Get Your Money in Better Hands

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