We’re glad you participate in the network

Encore is the health network that cares. We provide access to doctors your patients know, and hospitals they trust

EDI differs from remote repricing in that remote repricing allows payors to reprice claims themselves by accessing Encore’s database. EDI reprices automatically.

The Way EDI Works

Claims are directly transmitted from the provider or payor’s system into Encore’s ppoOne database. Then the claims are repriced by Encore and electronically transmitted to the payor without any paper exchange. Through EDI, claims get repriced more quickly, efficiently, and accurately.

The Advantages of EDI

The bottom line is, using EDI means less paperwork for your organization and faster claims turnaround. And because your staff will have less data entry, your data accuracy will increase.

Less data entry. Reduced costs. Improved efficiency. Greater accuracy. Don’t you think it’s time to talk EDI? Then call us toll free at 888-571-8180 and ask for Holly Joyce, Systems and Compliance Manager.

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My Payor Download



    If you have any questions, please contact webmaster@encoreconnect.com Special Authorization is required to access the Payor Updates.
    Please contact one of the following Account Executives for access:
    · Holly Joyce at (317) 621-4263 or hjoyce@encoreppo.com, or
    · Kevin McShay at (317) 621-4264 or kmcshay@encoreppo.com

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    Notice

    Encore has entered into a new arrangement for chiropractic services with HSM, Inc. HSM, Inc., a Minnesota-based specialty network services organization, will administer the chiropractic network for our Encore and Encircle service areas.

    HSM will directly hold contracts with all participating chiropractors; therefore, there are some changes of which you should be aware. Regarding billing, chiropractors will now send their claims directly to HSM. HSM will collect the data in their system, including treatment plans for case management, and forward claims to the appropriate Encore payor. The payor will send all payment directly to HSM, who will in turn reimburse the chiropractor according to the negotiated rates.

    If you are interested in becoming a participating chiropractor in the Encore Health Network, please contact HSM at 800-432-3640 or visit their web-site at www.hsminc.com.

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    Current Worker's Comp Payors

    Arete USA D/B/A The Covenant Companies
    HealthSmart
    HFN, Inc
    Indiana University
    InterPlan Health Group
    IU Health Plan
    MCMC LLC
    ASU Group
    Major Hospital
    ACS CompIQ Corporation, A Xerox Company

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    Payor and Provider Resources

    PAYORS: Please contact your Payor Account Manager, Fred Douse at (317) 621-4265 or fdouse@encoreppo.com or Kevin McShay at (317) 621-4264 or kmcshay@encoreppo.com
    PROVIDERS: Please contact Provider Contracting Coordinator, Logan Joyce at (317) 621-4262 or ljoyce@encoreppo.com.