Encoda

Encoda provides a Financial Health Management Platform designed to automate revenue cycle operations for physician practices. The company focuses on eliminating manual processes in claims management and payment posting through exception-based workflows and intelligent automation.

The platform integrates with existing practice management systems including athenahealth, Nextech, and Greenway Health to provide unified data visibility and automated processing. Core capabilities include pre-submission claims scrubbing with payer-specific rules, automated remittance validation and payment posting, exception-based work queues, and real-time analytics. The system automatically handles standard transactions and routes only discrepancies to staff for review.

Client testimonials report 96.5% first-pass payment rates, accounts receivable days under 28, and 25-40% productivity improvements. Named clients include multi-provider practices in cosmetic surgery, orthopedics, allergy/asthma, ophthalmology, and OB/GYN specialties ranging from 11 to 200 providers.

Consider Encoda when manual payment posting consumes significant staff hours, first-pass claim acceptance rates fall below 90%, or accounts receivable days exceed 35. The platform delivers value for practices frustrated by toggling between clearinghouses, payer portals, and PM systems to track claim status and reconcile payments.

Expect implementation focused on configuring exception rules specific to your payer mix and specialties. The system maintains your PM system as the source of truth while layering automation and analytics on top, avoiding disruptive data migrations.

Encoda exclusively serves the physician practice segment of healthcare with deep revenue cycle expertise. The platform embeds payer-specific billing rules, CPT/adjustment code logic, and specialty-specific workflows for orthopedics, ophthalmology, cosmetic surgery, allergy/asthma, and OB/GYN practices.

Client testimonials reference managing complex scenarios like remittance discrepancies, contractual adjustment automation, and denial code-specific routing. The company positions its solution as addressing the fragmented data and manual processes specific to medical billing operations rather than broader healthcare IT needs.

Best-fit clients are physician practices with 10-200+ providers experiencing revenue leakage from denied claims, extended A/R cycles, or staff overwhelmed by manual billing tasks. Practices already using athenahealth, Nextech, Greenway, or similar PM systems benefit from Encoda's integration approach that enhances rather than replaces existing infrastructure.