announced today that it has received certification from the
Centers for Medicare and Medicaid Services
(CMS) for the processing of Durable Medical Equipment (DME) encounter data for the CMS Encounter Data Processing System (EDPS).
With this announcement, Verisk Health becomes the first submitter to complete the CMS certification process for Encounter Data System (EDS) submissions. The company previously achieved Front-End Certification on the first day that CMS began the new Encounter Data System Front-End Testing certification process, and all Verisk Health clients have received Professional and Institutional End-To-End Certification.
“We’re proud to be the first to complete all aspects of the certification process. We believe it demonstrates the capabilities of our industry-leading EDS solution and team,” said Jamie Wells, chief operating officer, Revenue Integrity division, Verisk Health. “With the certification process complete, we’ll continue to refine our solution and support our clients with CMS-compliant production-encounter data submissions.”
Verisk Health leverages its risk adjustment and data management expertise to provide health plans with a comprehensive solution for EDS submissions and revenue management. The Verisk Health EDS Solution goes well beyond providing the mandated HIPAA-compliant (X12 5010 837 I, P) electronic data interchange. The integrated solution, featuring ReconEdge™ EDSQ, also includes high-quality automated data editing and cleansing, an automated workflow system for exception management, and robust analytical reporting — all to help health plans operate cost-effectively while managing revenue risk.
About Verisk Health
Verisk Health drives performance excellence in the business of healthcare. By combining clinical and analytics expertise with robust technology and services, we empower customers to fully leverage their data to achieve long-term measurable results. Verisk Health’s Revenue Integrity division (formerly Health Risk Partners) is a leading provider of risk adjustment services. The Revenue Integrity team has extensive experience working with federal and state healthcare payment methodologies and transforming them into solid business practices for Medicare and Medicaid health plans. Verisk Health is dedicated to helping its clients attain the highest levels of compliance, profitability, and strategic planning. Verisk Health is a subsidiary of Verisk Analytics (Nasdaq:VRSK). For more information, visit