Experience a smarter way to get paid on the first submission. With Encoda’s multi-layered claims scrubbing and predictive analysis, denials are stopped before they start. Our platform doesn’t just automate claim review—it learns from every payer interaction, continually adapting rules to today’s standards for maximum first-pass payment success. Empower your team to improve clean claims over time and reduce unnecessary rework.
Intelligent claims management
Minimize denials, accelerate payments, and ensure every claim is clean and trackable.
Precision, prediction, and payment—faster
Why claims fail and revenue suffers
Claims management is a complex maze of payer rules, specialty guidelines, and evolving requirements. Claims fail when payer rules change, manual review misses hidden issues, and teams are forced into reactive claim denial management. Outdated scrubbing methods catch only the most obvious issues, leaving practices to fix costly mistakes after claims are rejected or delayed. Unchecked, these challenges lead to mounting rework, slower payments, and a significant impact on your practice’s financial health. Common breakdowns include:
Only
20%
of medical practices are very satisfied with their current denial management process.
Just
37%
of practices are very satisfied with their practice management system’s ability to track claims.
Even after resubmission,
25-50%
still remain unpaid.
How Encoda elevates your claims process
Encoda transforms your claims management process from reactive to proactive. Our platform automates the entire claims lifecycle, giving you the tools to ensure accuracy, speed, and transparency from the very beginning. We focus on your true first-pass payment rate—not just claims that clear the basics, but those paid without human intervention. Our engine leverages your data and payer patterns for smarter edits and fewer downstream corrections.
Digital claim fingerprinting
Before claims even reach the clearinghouse, we apply a unique digital fingerprint to every line item. This lets you track each claim’s journey and verify payment against expectations.
Outcomes-based scrubbing
A multi-layered scrubbing process combines comprehensive national, local, and payer-specific edits with specialty libraries tailored to your practice. Custom rules address recurring denial trends, while real-time feedback and automated fixes resolve issues like missing modifiers before claims are submitted—dramatically reducing rework and denials.
Exception-based claim workflows
Instead of sifting through every claim, your team works only actionable exceptions, with prioritized work queues and guidance for faster resolution.
Proactive monitoring and alerts
Every claim is tracked, and if payment doesn’t arrive as expected, the system raises the flag—ensuring nothing is missed and improving your clean claim rate and overall efficiency.
Learn how to increase first-pass payment rates
Prevent denials and achieve financial health with our best-practice framework.
FINANCIAL HEALTH IN FOCUS
Transforming claims into revenue
Achieving industry-leading days in AR
With Encoda, Children’s Orthopedic & Scoliosis Surgery Associates gained clear visibility into first-pass payment rates, appeals, and claim corrections. By identifying payer and workflow issues early, their team reduced days in AR from 42.7 to 33.1—outperforming industry benchmarks for their specialty.
Streamlining AR with targeted rules
Encoda transformed Pediatric Health Care Alliance’s claims process by replacing generic, one-size-fits-all rules with targeted, flexible scrubs tailored by payer, plan, or CPT. With filtered work queues highlighting only adjudications needing attention, their team now works AR more efficiently than ever.
Doing more with less
Noran Neurology cut timely filing denials from a top 5 issue to just 1% in the first month with Encoda. This practice has not seen any timely filing denials in the past four months.
Why practices rely on Encoda for claims management
Encoda’s advanced rules management and exception-focused workflows deliver measurable
gains for your practice.
96.5% first-pass pay rate
On average, clients see over 96% of claims paid on the first submission, and this rate improves the longer you use Encoda.
Significant time savings
By surfacing only actionable exceptions, your team can focus their effort
on high-value claims and avoid manual busywork.
Fewer denials, less rework
Automated analytics, predictive edits, and rapid custom rule deployment
stop most denials before submission.
27.5 average days in AR
Across multiple specialties, our clients enjoy faster speed to payment, steady cash flow, and less back-and-forth with payers.
Clear, complete visibility
Digital fingerprinting and transparent tracking provide peace of mind from
claim creation to payment.
Ready to streamline your claims process?
See how Encoda can help you get paid faster and reduce the burden on your team.
