Learn About EDS

EDS (Encounter Data System) is the system required by MAOs (Medicare Advantage Organizations) to submit claims for Medicare Advantage (MA) encounters to CMS for reimbursement. Encounter data is used to determine the risk scores for payment.

EDS 101

• What is EDS/EDPS?
• Who needs to use EDS?
• What encounters and claims are submitted?
• Where does the encounter data come from?
• When do I submit the encounters?

TECHNICAL GUIDELINES

• What are the claim disposition codes?
• What format do I submit the encounters?
• How often do I submit the encounters?
• What are the file size limitations?
• What about errors and rejected claims?