CNSI recently announced our latest contract win, a 4.5 year, $35 million project to engineer the Centers for Medicare & Medicaid Services’ (CMS) Encounter Data Processing System. Although we here at CNSI understand the importance of the EDPS program, we realize that for most people out there, they may not know what this really means or why this system is so vital to the work being done at CMS. Therefore, here is a quick overview.
The Encounter Data Processing System, or EDPS, is the technological backbone of CMS Medicare Advantage—otherwise called Medicaid Part C. This is the system responsible for making sure providers are properly compensated for proper care. Encounter data, as it’s known, is the service record containing clinical and diagnostic information generated by health care providers during visits by beneficiaries.
CMS collects and analyzes the data centrally, then makes the appropriate changes to Medicare Advantage Organization reimbursements. Processing tens of millions of encounters weekly—and making the appropriate adjustments in a timely manner, as required by law—is a monumental technological task that is managed by the EDPS.
CNSI has worked on the existing EDPS for the past five years as a subcontractor. We have had a lot of successes including improving the processing platform to handle the skyrocketing number of encounters while significantly improving accuracy. We’re incredibly excited to take the reins and partner with CMS on this project. It’s huge in both scope and importance – millions of Americans depend on Medicare Part C. We’ll keep you updated on our progress as the project unfolds here on the blog.
If you have any comments (or congratulations!) please find us on Twitter @CNSCorp.