Payors reprice claims quickly, efficiently, and accurately with Encore new repricing option.

November 2006

As an insurance carrier, TPA or a self-administered employer, we know you are always looking for the best value in your network partnerships. That’s why Encore now offers a quick, efficient and accurate way to reprice your client’s claims.

New to Encore and transparent to the provider, is a paperless process for payors who wish to continue to receive claims but prefers Encore to reprice. EDI connectivity allows payors to transmit and receive claims electronically from Encore.

The Way EDI Works
Claims are directly transmitted from the provider or payor’s system into Encore’s database. Then the claims are repriced by Encore and electronically transmitted to the payor without any paper exchange. Through EDI, claims get repriced more quickly, efficiently, and accurately. Based on the needs of the payor, repriced claims can also be provided in paper format.

The Advantages of EDI
The bottom line is, using EDI means less paperwork for your organization and faster claims turnaround. Since payor’s EDI connectivity allows Payor to transmit and receive claims electronically from Encore, your staff will have less data entry and data accuracy will increase.

Less data entry. Reduced costs. Improved efficiency. Greater accuracy. Don’t you think it’s time to talk EDI? Then contact Kim Akers at 317-705-3241 or via email at kmakers@thcg.org.

Other Encore repricing options:
Standard Encore Repricing: Encore receives paper or electronic claims directly from the provider and reprices and sends to payor via mail.

Web-based Repricing: Encore’s Repricing On-line Claims System is an Internet-based claims repricing system providing Encore's clients a secure and easy-to-use solution for repricing claims. Our re-pricing system provides payors with the most current provider contract data and accurately reprice all of Encore's contracts, including fee schedules, straight discounts, and DRG's.

Payor repricing: Encore delegates fee schedules and provider files to payors to reprice claims.