Encoda announced today that Intensivist Billing, a national critical care billing and physician services company based in Pittsburgh, has chosen Encoda’s entire suite of products and services, including the Encoda patent-pending claims and exception management solution — M/EDI™; Encoda’s data warehouse and business analytic platform — M/EDI Information Generator™; and Encoda’s TIER-1 Hosting Service (which has not been down since 1996).

When contacted Connie Carey, Director of Billing, said, “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 PMS involved agonizing processes. We really couldn’t even measure the efficacy of our efforts without a huge amount of work. We had grown to a size from which we could neither grow further economically nor offer the same high level of service to the additional clients such growth would bring us.

“We even considered the incredibly expensive alternative of changing billing systems. But when we looked at other billing systems they all did pretty much what our system did.

“Then we heard about Encoda. We don’t have to get a new system or hire more people and we don’t need more billing system licenses. Encoda’s system bolts on to our existing billing system and appears to our billing system as only one user even though it can do an unlimited amount of work. It is both the system that runs the system and a super user. It makes our existing system do what it should have been doing all along.

“The first thing Encoda did was install their business intelligence and reporting tool. Last night was the end of the month. This morning the most incredible and sophisticated suite of reports was on my Intranet portal when I came in. That used to take us two calendar weeks and many hours of labor before. We would have to run reports and then use them to create Excel spreadsheets and then massage those and send those to our clients. It was a bloody nightmare. For several weeks their nightly automation programs have been doing various tasks we used to do using people. No more. Everything is automatic.

“And they have absolutely the best support we have ever had. When I am working on weekends so are they. When I am working at night, so are they. When I call I get people, not recordings. When we need them they are there. I know this sounds like an ad. But it is the truth. Thank you, thank you, Encoda.”

Robert Lee, President of Encoda, said, “We welcome Intensivist Billing into our growing community of clients. What we know is a result of serious and intimate collaboration with our clients. It is a two way street. The next step for Intensivist Billing is to port them over to our totally automated direct-to-payer transaction system, called M/EDI™. Not only will it reduce claims turnaround time significantly but it will enable them to use our single screen, paperless M/EDI™ Exception Management System which actually writes corrections back to their billing system and can fix hundreds of errors just by fixing one. It is not just a traditional denial system which comes into play at the time of the EOB. It captures every wrinkle at every step of the way. It even knows when things that should have happened did not happen.

“The billing processes that every billing system in existence today model are the mom and pop processes of the 1970’s, gussied up with electronic cake decoration. It does not matter what system you have. They are all the same when it comes to billing and analysis. Only the price tags are different. Oddly, when it comes to reporting the cheaper systems are better than the larger systems. The biggest practices have the clunkiest software. The two largest systems sold in the United States today were actually written before the invention of the relational database. You can’t fix that inside. These companies would have to swear off selling systems for five years, throw everything out and start all over again. The only economical thing you can do with these systems is write programs to drive them.

“Once Intensivist Billing has M/EDI™ rolling they should be able to increase their business by leaps and bounds with only minimal increases in expenses as well as offer their clients unparalleled turnaround times, liquidation ratios, and actionable information. In the first 20 months our initial client, a large pediatric practice, increased their revenue per physician by 30% and redeployed 40 FTE’s in their CBO. That client actually got a $1.6 million payer settlement using our information. Total improvement to this practice after 20 months was $40 million.

“Everyone claims to do what we do. But nobody does. RCM, management by exception, queues, X12, ANSI, integration—they are all buzz words. Clearing houses even claim to do what we do. How could they? By their very nature they can’t. It is all explained on our website.”

About Encoda

Headquartered outside Philadelphia, PA, Encoda (www.encoda.com) is a software, technology and service solutions provider for a broad mix of physician practices and physician-servicing businesses. It is a company of technologists run by technologists.

With its patent-pending product, M/EDI™ and M/IG™, Encoda has changed the paradigm for practice management systems and revenue cycle management. Developed in strict conformance to ANSI X12 specifications, this solution enables medical delivery units to keep their existing billing systems but handle virtually unlimited amounts of billing data with perfect accuracy and economies of scale; to bypass clearing houses and legacy appeals processes; and create merged actionable information from the data in their practice management system and their payers systems.

For those clients requiring a modern, integrated PMS/EHR Encoda offers and supports Greenway PrimeSuite, rated #1 by KLAS. Clients may purchase Greenway PrimeSuite with or without the Encoda M/EDI™ and M/IG™ offerings.

About Intensivist Billing

Intensivist Billing (www.intensivistbilling.com), headquartered in Pittsburgh, PA, is a national ICU centric services company offering expertise in critical care medicine consulting, billing and recruitment to hundreds of critical care physicians. It is physician-owned and physician-led; its principals understand intimately the needs of its clients. Among the services offered by Intensivist are billing, reporting, data analysis, business process consulting and full OIG and Federal Sentencing Guidelines compliance consulting.




Intensivist Billing

Connie Carey, (412) 822-7290

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