Submissions & Reconciliation

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.