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Search keyword: encounter data management hospitals
Encounter Data Management
Better evaluate the performance of your provider network
Improve the performance of your provider network by cost effectively receiving your claims and sub-capitated encounter data over the web with TransUnion Healthcare ClaimsREDI.
Our robust web-based data capture and cleansing system collects, scrubs and aggregates both claims and sub-capitated encounter data from multiple input formats to help you affordably and efficiently obtain all your claims and sub-capitated encounter data.
Our robust web-based data capture and cleansing system collects, scrubs and aggregates both claims and sub-capitated encounter data from multiple input formats to help you affordably and efficiently obtain all your claims and sub-capitated encounter data.
- Eliminate paper submission and re-keying/scanning of claims and sub-capitated encounter data
- Identify and manage errors associated with errant or incomplete data
- Reduce the costs of capturing accurate data from multiple sources while easily supporting various input formats
Encounter Reconciliation System
This flexible management tool allows you to track and accurately account for encounter data in a way that makes the most sense for your organization. We validate and edit data in accordance with your edit logic to seamlessly work with your systems and processes.
ClaimsREDI System
This flexible management tool allows you to track and accurately account for claims and sub-capitated encounter data in a way that makes the most sense for your organization. The web-based system validates all incoming data and then exports the processed data in accordance with your specifications so that it can seamlessly work with your systems.
Increase accuracy with a more intelligent process
TransUnion Healthcare captures claims and sub-capitated encounter data from rendering providers, labs, hospitals and other provider organizations with a process that facilitates obtaining that data timely and cost effectively.
- Data is captured from the submitting source in any format or medium
- Non-standard data is translated, then edited
- TransUnion Healthcare Encounter Monitoring System automatically validates member IDs, rendering and referring provider IDs, dates of service and diagnosis and procedure codes
- TransUnion Healthcare then delivers primary reports, including transactional and file summaries, error status and adjudication results/payer rejections
Beyond the primary reports automatically generated, we can also provide additional services such as:
- Web-based direct data entry for submitters that cannot transmit data electronically
- Member validation on all submitted data so that you don’t receive claims that aren’t yours
- Single sign-on integration with your provider portal
- ANSI 4010/5010 bi-directional conversion services
- RX data exchange in a consistent and simplified data format
See how you can improve physician group performance with accurate and complete claims and sub-capitated encounter data.
