Encoda BackOffice

This feature handles claim submissions and ensures they are accurately transmitted to payers. It acts as a bridge between your practice management system and payers, offering seamless integration. Claims Manager provides a centralized platform to manage claims, reducing the chances of errors and eliminating the need for manual intervention.

The exception manager identifies exceptions, discrepancies, and errors within the claim's workflow. It acts as a safeguard, preventing problematic claims from progressing without resolution. Moreover, it notifies users of differences, enabling them to take timely corrective actions and maintain a smooth claims submission and reimbursement cycle.

The watchdog feature ensures that responses from payers are received for all claims that have been submitted. It acts as a vigilant guardian, flagging any missed or delayed responses. By continuously tracking claims status, Watchdog empowers billing teams with accurate insights, facilitating efficient follow-up and minimizing revenue leakage.

The payment manager seamlessly integrates with your practice management system to automate the payment recording. As payments are received, the Payment Manager accurately records them, reducing the manual effort required for payment reconciliation. This feature enhances accuracy and efficiency while contributing to streamlined financial management.

Claims scrubbing encompasses a range of processes, incorporating NCCI, LCD, NCD, and MUE regulations, identification of ICD-10/CPT disparities, overlooked CPT codes, and addressing payer-specific bundling and frequency rules and regulations. This is done by utilizing a specialty-specific edit library and custom demographic scrubbing, enabling billing teams to perform efficiently and enhance profitability.