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

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.

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.

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.

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