EncoderPro.com for Payers from Optum360 is the industry frontrunner in provider and facility coding information and compliance.
This online coding tool includes ICD-10-CM and PCS, CPT, DRG and HCPCS Level II code set searches, Medicare Part A and B policy information, the Medicare Physician Fee Schedule, and a full library of publications from Optum360.
With the power of EncoderPro.com for Payers, you'll more accurately research coding and compliance rules, easily find elusive codes, and quickly access supportive documentation.
EncoderPro.com for Payers is a highly functional browser based solution that puts all the coding tools you need right at your fingertips.
For easy navigation throughout the application, use the convenient single click buttons to access user notes and code notes across your organization. A list of your most commonly used codes, online help, unparalleled claim review, and more.
Or take advantage of the quick links to code book resources such as indexes and appendixes that drill directly down to content designed specifically for code research and review.
Every aspect of EncoderPro.com for Payers is designed to drive you to the appropriate code, keep you updated on code revisions, and alert you to upcoming changes.
Users that are accustomed to the formats of traditional code books will appreciate how the EncoderPro.com for Payers' menus are arranged in sections identical to the books.
Here's how code lookups work. EncoderPro.com for Payers lets you search up to four lay terms, abbreviations, acronyms, and even misspelled words across CPT, HCPCS, ICD-9-CM and ICD-10-CM and PCS code sets to retrieve clinically accurate search results, all in less than a second.
EncoderPro.com for Payers clearly displays results across code sets and allows you immediate access to code sections and detailed code pages with Medicare content, lay descriptions, coding tips, section guidelines, images, code history, and multiple crosswalks.
Convenient color coded edits identify whether a code carries an age or sex edit is covered by Medicare or contains bundled procedures.
All the essentials are attached to each and every code so that even a beginning user can reference the correct codes with speed and accuracy. EncoderPro.com for Payers' dynamic search engine extends across ICD-9, ICD-10, and HCPCS as well.
EncoderPro.com for Payers provides enhanced facility reference content, delivering encoding guidelines concerning DRGs such as DRG Trees for major diagnostic categories as well as information surrounding DRG indicators and targeted DRGs. It also includes a DRG and code lookup for all the major diagnostic categories. EncoderPro.com for Payers provides a wealth of additional information to aid in accurate facility claim review such as referential data regarding Medicare secondary payer or MSP. You also have access to reference content to correctly adjudicate claims across physician clinics, AFC, and hospital inpatient outpatient settings, and a complete revenue code to CPT HCPCS lookup, as well as revenue codes that require CPT HCPCS codes.
When it comes time to check your work and review coding guidelines and coding relationships, EncoderPro.com for Payers includes a compliance editor. Simply enter your criteria and the compliance editor reviews your coding information, automatically checking the code selections against over 120 Medicare edits and 100 commercial payer edits and even state specific Medicaid edits, including local and national coverage determinations, medical necessity, CCI and bundles, age, gender, modifier, and much more. EncoderPro.com for Payer customers can even enter batched claim information for review across multiple claims simultaneously.
EncoderPro.com for Payers provides additional methods to ensure correct code usage. With its unique embedded note-taking capability, EncoderPro.com for Payers lets you attach your own personal notes or global notes that can be seen by every user across your organization.
EncoderPro.com for Payers user notes can be organized by specialty and/or payer and can be much more effective than traditional notes in the margins of coding books.
If you need to reference a new code or revised code or to review lists of these codes that have indications such as age and gender, EncoderPro.com for Payers makes this information readily available, even providing a quick and easy crosswalk to all codes that have been deleted since 1998. If that code has a recommended replacement, a hyperlinked cross reference to the new code will be visible.
Want to look up active and retired local coverage determination and national coverage determination policies? EncoderPro.com for Payers users can quickly query this information across carriers, or for individual carriers for Part A or Part B policies, and to make searching easier offers many ways to do so by procedure or diagnosis code, keyword or policy ID. Printing code content has never been easier or more customizable for any coding information across all code sets. This custom printing offers more customization rather than being limited to printing a generic sheet that includes every detail. EncoderPro.com for Payers is guaranteed to meet your unique business requirements. Direct access to the content of over three dozen code and reference books ensures that you'll find what you need, plus there are specific add-on modules that allow even more specialized information to be included. To review these available add-ons and all their valuable content and functionality, review the add-on video that provides detailed information about each of these available add-ons. In addition to these helpful add-ons, EncoderPro.com for Payers provides an additional option to integrate reference data for pharmaceutical payments with searches based on drug description, manufacturer, J Code, or NDC. This integration known as DrugReimbursement.com includes a crosswalk from NDC to J Code and J Code to NDC. While the DrugReimbursement.com integration is purchased in addition to EncoderPro.com for Payers, it's an invaluable tool when researching claims containing pharmaceutical charges as it gives the user complete access to NDC, packaging information, bill units, and AWP.
EncoderPro.com for Payers from Optum360 empowers payer organizations to streamline process control, shorten claim cycles, and take on higher caseloads while improving overall customer satisfaction and retention.
To learn more about EncoderPro.com for Payers from Optum360, please contact us today.
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