Encoda

Encoda is a Financial Health Management Platform that seamlessly integrates with Prime Suite and Intergy to give physician practices greater control, visibility, and efficiency across the revenue cycle. By unifying billing, clearinghouse, and payer data into one intelligent interface, Encoda helps practices get paid faster, reduce denial-related delays, and make confident, data-driven financial decisions—without overburdening billing teams or relying on disconnected systems.

Encoda transforms fragmented revenue cycle processes into a streamlined, proactive workflow built around Actionable Revenue Transparency—the ability to see what matters, understand what’s happening, and take timely action. With real-time visibility into claims, payments, denials, and payer performance, Encoda enables practices to surface trends, flag revenue at risk, and respond before issues impact cash flow. The platform also offers clear views into aging trends, denial rates, patient collections, and overall financial health—equipping teams to manage the revenue cycle with confidence.

Encoda is designed to empower billing teams. Its intelligent work queue highlights only the items that need attention—whether it’s a denial, a missing response, or a claim stuck in limbo—while customizable workflows and payer-specific rules speed up resolution. Encoda’s intelligent rules engine applies industry-standard edits and supports tailored rules by payer, plan, or specialty to increase accuracy and ensure more claims are paid on first submission. The platform adds another layer of control by flagging submitted claims that haven’t been accepted, denied, or paid—providing unmatched visibility into what’s stalled and why.

Practices using Encoda consistently achieve meaningful financial results. On average, clients see a 95% first-pass insurance payment rate, 25–40% improvements in billing team productivity, and just 27.5 days in AR. For Intergy and Prime Suite users, Encoda offers a purpose-built path to greater reimbursement speed, reduced rework, and sustainable financial performance. By turning the revenue cycle into a strategic asset—not just a back-office function—Encoda helps practices eliminate blind spots, uncover hidden revenue, and drive better financial health outcomes across the board.

Solution Features

• Seamless bi-directional integrations with Prime Suite and Intergy honor Greenway as the system of record while enhancing with advanced billing, automation, and analytics capabilities.
• Actionable analytics offer real-time views + AI-empowered insights into claims, denials, payments, aging, payer performance, and billing team productivity to inform timely decisions.
• Exception-based work queues surface only claims and payments that require staff attention—reducing rework and boosting productivity.
• Intelligent claims management applies industry-standard and custom rules to prevent denials, ensure clean claim submission, and boost first-pass payment rates.
• Automated payment management streamlines cash posting, flags discrepancies, and accelerates payment accuracy with minimal manual effort.
• Claim monitoring identifies claims submitted but not yet accepted, denied, or paid—preventing silent stalls in the revenue cycle.
• Custom rules engine supports specialty- and payer-specific automation to fix recurring issues and improve speed to payment.
• Closed-loop workflow optimization tracks the impact of automation and rule changes, enabling continuous improvement of revenue cycle performance.

Customer Testimonials

“Since implementing Encoda our team has collected on average 7.5% more revenue…We’ve also streamlined our operations and gained insights for our practice leaders that were previously difficult to identify in just our practice management system alone.” 

– ENT Associates