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Encounter and Clinical Data Processing

Improve healthcare transaction management with robust data and analytics to enhance clinical outcomes.

Streamline healthcare data processing approaches to drive efficiencies and enhance care.

Encounters and Claims Management

Fill in gaps associated with different payment models through improved management of encounter data processing. Our solution:

  • Enhances first-time acceptance rates, creates custom submitter rules and provides insight into transaction status
  • Offers dedicated expertise and account monitoring to ensure consistent data submissions
  • Validates and applies edits to ensure data integrity
  • Accesses robust, accurate encounter data to improve risk adjustment payments and quality metrics
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Clinical Data Clearinghouse

Find missing clinical data and increase provider connectivity to inform HEDIS, STARs, risk adjustment and overall population health management. Our clearinghouse solution manages hard-to-format, supplemental clinical data from laboratories, physician offices and other databases to:

  • Reduce operational and developmental burdens of submissions
  • Improve data quality by customizing rules and identifying missed or duplicate data elements
  • Improve member matching

Payer Dashboards

Timeliness Insight Dashboard

Gain visibility into the full encounter cycle and timeliness of transactions by:

  • Identifying where data lags occur
  • Pinpointing data delays
  • Monitoring month-to-month performance

Error Insight Dashboard

Improve efficiencies by:

  • Analyzing rejected encounters by date of service and managed service organization
  • Identifying top error types for prioritization and resolution
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Provider Organization Dashboard

Submitter Insight Dashboard

Improve turnaround times and success rates of encounter transactions. This dashboard:

  • Provides volume trend and error resolution insights
  • Tracks acceptance and rejection rates
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“All required reports are provided, allowing us to track end-to-end encounter submissions.”

- Western US Management Service Organization

“I’ve worked with TransUnion for many years. They make submitting encounters to our business partners a smooth process and provide excellent customer service.”

- West Coast Physician Network

“TransUnion outperforms all of our other clearinghouses. Our networks are appreciative of ClearIQ’s easy-to-use interface.”

- West Coast Health Plan

“TransUnion is very detailed, organized, timely, knowledgeable and professional. Working with them is effortless.”

- National Health Plan

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