Improve Claims Quality, Reduce Adjustments

Under pressure to control administrative costs? We’ve helped the US’s top healthcare insurers save tens of millions of dollars by improving claims adjustment rates and eliminating overpayments with Enkata Claims Performance.

We can help you too. Stop spending your time spot-checking claims when you can inspect every reworked claim to identify the root cause of adjustments. Start on the path to a 2% adjustment rate today.

Decrease Costs, Improve Quality with Enkata Claims Performance

Calculate claim adjustment rate for processors. Only Enkata calculates a claim adjustment rate that indicates the original processor that caused the adjustment. Pinpoint the 20% of processors causing 80% of your adjustments.
Identify the root causes of adjustments. Enkata lets you drill into adjusted claims at the claim line level to quickly identify the cause of payment errors.
Empower employees to self-correct. Processor dashboards show individual performance for adjustments, clean claim rate, claims per hour, etc. compared to peers and targets.
Prioritize improvement opportunities. Enkata breaks down metrics by claim type to rank by importance.
Coach the right employees on the right topics. Automated coaching plans identify the highest priority claim adjustment reasons or procedure codes driving a high adjustment rate versus peers or targets.

Want to decrease costs and improve quality? Request a demonstration to see Enkata Claims Performance firsthand.