Reconcili8

Submissions & Reconciliation

Ensuring accurate, timely, and complete EDPS/RAPS and EDGE Server Submissions with a scalable, flexible, and integrated solution

Pulse8 understands that the volume of data required for today’s government programs, along with their complex and ever-changing regulations, can be overwhelming.  Reconcili8 eases those burdens with end-to-end submission and reconciliation processes that ensure regulatory compliance and mitigate revenue leakage.  

Key features making Reconcili8 the most flexible and reliable submissions solution:

  • Consolidated encounter book of record for end-to-end visibility into member claims data and for complete and accurate tracking and status-monitoring of all encounters
  • Configurable workflows for batch corrections, reviews and approvals, and re-submissions to enhance workforce efficiency
  • Seamless EDI channel connectivity via integration with our industry-leading trading platform

Reconcili8 is flexible enough to accommodate your plan’s custom business rules and versatile enough to support the regulations, format changes, and workflows specific to the ACA Commercial, Medicare Advantage, and Managed Medicaid markets.

Reconcili8 consumes your claims and encounter data for EDGE Server and EDPS/RAPS submissions that will meet all CMS data requirements.  While striving for 1st-pass acceptance, Reconcili8 provides an efficient platform for managing errors, exceptions, corrections, and re-submissions.  Plans can use our web-based portal to manually enter supplemental data and export approved supplemental transactions for processing to the destination entity.

Firm up your revenue reconciliation with improved encounter data quality, precise risk analytics, and accurate revenue forecasting.  Cut your administrative and audit costs with streamlined exception and reject management workflows and built-in encounter correction utilities.  Finally, as a hosted solution, Reconcili8 delivers these benefits with reduced IT costs.

Reconcili8 is Pulse8’s reliable and flexible solution for timely, accurate, and complete EDPS/RAPS and EDGE Server Submissions.

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For all general and sales inquiries, please contact us at 410.928.4218 or email us at info@pulse8.com
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