DCA Dynamic Commerce Applications

Encounter Reporting Infrastructure (ERI™)

Increase Revenue with DCA's ERI™

The Encounter Challenge

Medicaid & Medicare managed care organizations desire an intuitive infrastructure and cost-effective operation for Encounter Reporting in order to achieve the highest acceptance level and maximize their revenue on a consistent basis.

DCA can help you to overcome these challenges.

	DCA has a major focus in enabling Managed Care Organizations (MCO) and their subcontractors to report their Medicaid/Medicare Encounter completely, accurately, and timely in a cost effective and efficient way.
	DCA has enabled MCOs to significantly reduce their total cost of ownership of Encounters processing while achieving over 98% acceptance rates for better scoring and Risk Adjusted payments as well as avoiding penalties.
	DCA Medicaid/Medicare Encounter Reporting services for an MCO ranges from minimal support services to full system/operation solution. DCA's ERI™ covers business operations, relationship management, and actual encounter processing that includes initial submission, reconciliation, adjustments, corrections, and resubmissions.

For an MCO, our range of services is from short-term engagements to ERI™ services.

The short-term (as short as 2-15 days) engagements cover areas such as overall assessment, generating roadmaps, error handling, submission, and reconciliation. In such engagements DCA enables a MCO encounter team to achieve a crucial level of efficiency and productivity in a very short period of time by collaborating with the DCA team.

ERI™ provides a comprehensive operation/technical service that cover ongoing operation, analysis/mapping, building/formatting/submission of initial encounters, void encounters, replacement encounters, return processing (reconciliation, adjustment, correction, resubmission), and integration as well as establishing/operating Agile Encounter Centers.

ERI™ components for processing Medicaid/Medicare Encounter Reporting handle a number of other functions including: storing the relevant Claim/Provider/Member information, providing capabilities for error reviews, and a web-based statistical/financial reporting component that provides error queues for integration. DCA implements ERI™ solutions very rapidly and cost effectively for the following reasons:

	offers ERI™ software-as-a-service that enables an MCO to achieve a high level of efficiency and cost effectiveness in operation and process
	has successfully implemented Encounter Reporting systems and managed the operation of several Lines of Business in various states
	has successfully enabled MCOs to reduce the total cost of ownership of encounter processing, avoid penalties, and achieve acceptance rates necessary for better scoring and Risk Adjusted payments

DCA has focused on Medicaid/Medicare Encounter Reporting since 2000. DCA has been a solution provider and its ERI™ services would enable plans to achieve the highest level of complete, accurate, and timely Encounter Reporting with no additional burden on a MCO IS department.

Submission, reconciliation, correction, adjustments, and resubmission of Encounter data are critical in documenting quality scores and establishing payment rates.

For Medicaid, implementation in some states has been exceptionally complex and technically challenging. In addition, they have presented relationship management challenges with policy makers in state agencies and with the fiscal intermediaries who process data on behalf of the states.

As a direct result of DCA's efforts, clients have met data acceptance targets and have significantly improved system productivity. DCA's Encounter teams consistently has overcome obstacles by finding creative solutions (both technically/operationally) and managed the external relationships that are key to Encounter Reporting success.