Health Risk Partners (HRP), the Revenue Integrity Division of Verisk Health and a leading provider of healthcare risk adjustment services, announced it received certification from the Centers for Medicare and Medicaid Services (CMS) for successful completion of the Encounter Data System Front-End Testing. The new Encounter Data Processing System supports CMS’s rapidly evolving role in the delivery, management, and payment of healthcare services. CMS is requiring certification for the submission of Medicare Advantage plan encounter data, scheduled to begin today, January 4, with CMS End-To-End testing followed by production data submission.
As of December 2011, HRP has received CMS certifications for more health plans than any other third-party submitter.
“Health Risk Partners was certified on the first day that CMS began the new Encounter Data System Front-End Testing certification process, which demonstrates HRP’s institutional knowledge and market expertise, as well as our ability to put our clients’ interest and needs at the forefront,” said Jamie Wells, chief operating officer at Health Risk Partners. “We have significant experience working closely with CMS and in building custom processes that are compliant with CMS requirements, so our clients are confident and secure in knowing revenue is not being put at risk. Further, we believe our clients will maintain a competitive edge while we add value to the integrity of the data submitted to CMS to drive its reimbursement programs for the future.”
HRP leverages its risk adjustment and data management expertise to provide a comprehensive solution to support health plans with EDS submissions and revenue management. The HRP solution goes well beyond providing the mandated HIPAA-compliant (X12 5010 837 I, P) electronic data interchange. HRP’s integrated solution, featuring ReconEdge™ EDSQ, also includes high-quality automated data editing and cleansing, an automated system for exception management, and robust analytical reporting — all to help health plans operate cost-effectively while managing revenue risk.