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What is EncoderPro.com?

EncoderPro Spotlight, created by OptumCoding, serves as an indispensable online medical coding reference tool designed to support those working in ambulatory coding, billing, and reimbursement by ensuring they have timely and accurate access to a variety of coding systems, including CPT, HCPCS Level II, ICD-10-CM/PCS, and ICD-9-CM, along with essential regulatory insights; this innovative software is equipped with powerful search and reference capabilities that compile a wide array of procedure, service, supply, and diagnosis codes, complemented by detailed descriptions and cross-coding information, enabling users to quickly locate the correct codes and reduce the likelihood of submission errors. Beyond basic code listings, the platform also supplies specialized content and tools that deepen users' comprehension of compliance matters, covering areas such as National Correct Coding Initiative (NCCI) edits, Hierarchical Condition Categories (HCCs), and guidelines on coverage determinations, while also incorporating automated review functions for proper unbundling and modifier usage, along with a thorough historical content database essential for adjudication. As a result, EncoderPro Spotlight not only aids coding professionals in their quest for precision and efficiency but also empowers them to navigate the intricate world of medical coding with greater confidence. Ultimately, the tool stands out as a vital asset for anyone striving to excel in the ever-evolving field of medical coding and billing.

What is Context 4 Health Plans Suite?

Ensure the dependability of your health plan while identifying precise pricing through the Context4 Health Plans Suite, our adaptable and cloud-based technological solution. Gain immediate and actionable insights for identifying Fraud, Waste, and Abuse (FWA), crafted by our team of certified experts proficient in clinical, dental, and health benefits. By utilizing reliable data along with cutting-edge cloud technology, we provide a strong and justifiable Medicare reference-based pricing (RBP) solution. Our platform integrates over 100 healthcare data sets, further enhanced by expert guidance to improve operational efficiency and maintain regulatory compliance. Moreover, our advanced medical coding software is designed to facilitate claim submissions and minimize the chances of denials. In addition, our cloud-based Payment Integrity Platform employs a distinctive analytics engine to detect coding errors, evaluate medical necessity, tackle unbundling, and identify fraud, waste, and abuse, while also assessing audit risks and uncovering pricing inconsistencies that could greatly impact your organization’s overall performance. This all-encompassing strategy not only protects your financial stability but also equips you for lasting success in the dynamic healthcare environment. With our commitment to innovation, you can navigate challenges with confidence and ensure a future of continued growth.

Media

Media

Integrations Supported

Virtual Benefits Administrator (VBA)

Integrations Supported

Virtual Benefits Administrator (VBA)

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Optum

Company Location

United States

Company Website

www.optumcoding.com/online-coding/encoderpro-spotlight/

Company Facts

Organization Name

Context4 Healthcare

Date Founded

1988

Company Location

United States

Company Website

www.context4healthcare.com

Categories and Features

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

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