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Leverage our encounter data error management and submissions tool to gain visibility into errors and ensure you are accurately reimbursed by CMS.
Health plans often lack visibility into the errors that exist within their encounter data, leading to incomplete submissions and lost revenue. To help solve this issue, we created Episource Submitter, a cloud-based SaaS encounter data management and risk adjustment encounter submissions platform that works for every model within the Medicaid, Affordable Care Act, and Medicare Advantage markets.
With our solution, health plans can identify and fix encounter data errors, reconcile RAPS/EDS files, and estimate accurate financial projections.
Our analytics team will create summary-level dashboards for file and financial comparisons making reporting easier and saving time. These reports include operational summary report, submission by DOS report, HCC discrepancy report, RAF projections report, top 10 rejections report, payment summary report, audit report, and provider-level reporting among others.
We identify and prevent data leakage with HCC analysis and discrepancy reports at member level between the EDS and RAPS systems. Additionally, we flag all claims with HCC codes as “risk adjustable” and then identify the list of HCC codes populated on the claim. Following that, we filter rejected claims based on the count of HCC codes present.
With Episource Submitter, you can leverage a secure cloud-based platform that is accessible 24/7 via an online client portal through any browser.
With Episource Submitter, you will be provided with a quick timeline, ~3-6 weeks from ingestion to being able to use the app seamlessly. You will also receive support at all stages, from RAF program error correction to CMS error mitigation.
Accurate RAPS/EDS reconciliation
Improved accuracy and compliance in risk adjustment submissions
Easier and more time-effective reporting
Identify, prioritize, and track submission errors
acceptance rate at 999 level
acceptance rate at 277 level
acceptance rate at MAO-002
Episource’s knowledge and expertise have really helped take our risk adjustment program to the next level.
They’ve added in features where we can actually see the campaigns in real time and watch it progress through the dashboards and get all kinds of great reporting.
Their solution far and away exceeded what we were being offered by other vendors at the time, and they were very easy to work with right out of the gate.
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