Customized Rules to Automate Claims Processing
Bill Cox is the co-founder and Chief Technology Officer of Encoda.
In this short video, Bill describes part of the original mission of Encoda as he and the development team set out to automate manual claims processes found in medical billing offices.
Bill explains what true claims automation is and how Encoda clients use their own business logic by payer, by provider, by CPT code, etc., to create customized front-end and back-end, pre and post adjudication rules to automatically process claims that do not need to be touched, as the software places only those claims requiring attention in one queue, on one screen for billing teams to work.
As a result, Encoda clients do not have to toggle back and forth between the practice management system, clearinghouse, and payers, which improves workflow, increases reimbursement, automates electronic payment posting, reduces days in A/R, and reallocates or reduces FTEs.