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Solventum™ 360 Encompass™ Audit Expert System — Outpatient Prebill Review

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Streamline audits. Elevate compliance. Empower accuracy.

The Solventum™ 360 Encompass™ Audit Expert System for Outpatient Prebill Review is an advanced, AI-powered solution designed to help healthcare organizations proactively identify and correct coding errors before claims are submitted. By automating audit workflows and integrating seamlessly into existing revenue cycle processes, this system reduces denials, minimizes rework, and enhances both coding accuracy and documentation completeness.

  • Identify and correct coding errors before claims are submitted, reducing denials and rework.
  • Automate audit workflows with AI-powered recommendations, enabling faster and more efficient reviews.
  • Enhance coding accuracy and documentation completeness to minimize revenue leakage and regulatory exposure.
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Review early and resolve quickly

Integrated within the Solventum™ 360 Encompass™ System workflow, Solventum Outpatient Prebill Review creates an efficient process to address coding reviews, audits and compliance challenges to improve quality and maintain compliance.

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Streamline audit processes with AI-driven insights

Arguably more than ever, outpatient care providers are feeling pressure to optimize revenue cycle performance — while remaining compliant — amongst ever-evolving coding and regulatory requirements. The complexity of outpatient coding however, combined with staffing shortages and high claim denial rates, makes it difficult for health systems and physician groups to maintain financial and operational efficiency. Without a robust pre-bill auditing process, organizations risk claim errors, revenue loss and payer scrutiny.

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Ensure accurate and compliant coding before claim submission

Solventum’s Outpatient Prebill Review solution leverages advanced AI and automation to review outpatient claims for discrepancies in coding and documentation before submission. By proactively correcting errors, organizations can reduce claim denials, accelerate reimbursement and ensure compliance with payer requirements. This solution integrates seamlessly into existing revenue cycle workflows, empowering healthcare organizations to maintain coding integrity, optimize revenue capture and mitigate audit risks.

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Leverage Solventum™ 360 Encompass™ Audit Expert — Inpatient Prebill Review

You can leverage your pre-existing Solventum 360 Encompass Inpatient Prebill Review functionality with ambulatory content. Its workflow supports edit-driven second level reviews (or additional reviews as specified) and is integrated within Solventum 360 Encompass, offering:

  • Communication tools for reviewers and coders
  • Visual indicators for suggested changes
  • Information tracking for further reporting
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Key elements available for actionable second level review edits

  • Revenue code
  • Total charges
  • Ambulatory Payment Classification (APC) claim edits
  • Solventum™ Enhanced Ambulatory Patient Groups (EAPG) claim edits
  • Current Procedural Terminology® (CPT) codes
  • Healthcare Common Procedure Coding System (HCPCS)
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Learn more about Solventum’s outpatient revenue management solutions

Using a single vendor to manage the full scope of outpatient revenue can help create a more connected and efficient process across the care journey. It can reduce handoffs, minimize revenue leakage and give teams a clearer view of performance.

By supporting pre-visit, post-visit and pre-bill workflows, this approach can help hospitals identify documentation gaps earlier, apply accurate codes faster and catch issues before claims go out the door

We’ll show you how
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