MIAMI LAKES, Fla., April 19, 2012 (GLOBE NEWSWIRE) -- Altegra Health, Inc., a leading technology-enabled services provider for risk adjustment, data analytics, and encounter reporting, today announced it has received certification in Encounter Data End-to-End Testing from the Centers for Medicare and Medicaid Services (CMS).
Altegra Health became certified in Encounter End-to-End Testing Certification as a Third Party Submitter by submitting data for testing to the CMS Encounter Data Processing System (EDPS). The company previously achieved Front End Certification in December 2011.
"Altegra Health continues to lead the health care services market in encounter reporting, risk adjustment analytics and data management," said Kevin Barrett, Altegra Health President and CEO. "Third-Party Submitter certification in Encounter Data End-to-End Testing from CMS is a reflection of this expertise and of our commitment to providing our customers with the solutions they need to ultimately improve patient outcomes."
CMS collects diagnosis data from Medicare Advantage plan providers for actuarial purposes - to determine the risk adjustment factors used to adjust plan payments and update risk adjustment models for plan payment. New for 2012, CMS will require health plans to comply with Encounter Reporting, transitioning from RAPS-based submissions to the new version 5010, EDI837-format encounter data submissions.
Altegra Health's industry-leading Encounter Reporting Infrastructure (ERI™) anticipates this requirement by formatting the data into an encounter and submitting it to CMS. Altegra Health's ERI web-based Software-as-a-Service (SaaS) solution provides a single source for error reviews, claims reporting, statistical analysis and financial reporting. The company's certification in Encounter End-to-End Testing validates that data is received, processed and priced by EDPS, which then provides reports to the submitter.
The CMS third-party certification process will ultimately allow accurate pricing for professional, institutional and Durable Medical Equipment (DME) encounters. CMS has begun certifications for professional encounters and will soon begin processing certification requests for institutional encounters. The agency is expected later this year to establish the parameters for how it will certify third-party submitters for DME encounter data.
About Altegra Health
Altegra Health leads the industry by aligning its best-in-class resources with health plan and provider clients' existing resources resulting in comprehensive, integrated solutions for Wellness Continuity Management™, eligibility and enrollment, and quality. The company is uniquely positioned to provide solutions that enhance member and provider experience, strengthen compliance, and improve overall performance. For information, please go to www.altegrahealth.com.