Encounter Data Submissions & Consulting

Accurate encounter data submissions have never counted more.

CMS and state Medicaid Agencies are putting more emphasis on encounter data when setting rates and determining risk-adjusted payments. So the accuracy of encounter data submissions can have a significant impact on both your audit risk and revenue. Count on our experts for Medicare and Medicaid data support.

Meet Our Experts

For the best encounter data outcomes, rely on Wakely’s tools and submission services.

Wakely offers comprehensive encounter data support, including:

Full-service submissions: We work with you to ensure there is no leakage in the data submitted. Our proven processes, backed by extensive encounter data expertise and actuarial skills, ensure that submissions to CMS are complete, accurate, and timely, and that revenue numbers are correct.
Submission oversight tool: Our online management tool:
- Allows health plans to easily understand and prioritize errors that need to be resolved
- Details the financial impact of any outstanding errors.
- Provides high-level data your CFO needs to understand, while still providing all the details needed for those resolving the errors
Assessment and consulting: Our expert consultants will partner with your team, discussing results and providing suggested improvements throughout the process.

We get results for our clients.

Both our Medicaid and Medicare plan clients have increased the accuracy of their encounter data submissions, saving them time and money.

Medicare Client Results:

Encounter claim rejection rate < 1.0% (national average: 3.0% – 6.0%)
Encounter line rejection rate < 1.0% (national average: 4.0% – 7.0%)

Minnesota and Wisconsin Medicaid Client Results:

Clients are consistently at the top of state-defined metrics and benchmark reports
Penalty dollars for encounter errors for our clients have been $0 for multiple reporting periods

Wakely’s expert encounter and actuarial consultants, combined with our access to a wide range of data sources, allow us to regularly deliver results that exceed our clients’ expectations.