2026 Reimbursement Reset: A Framework for First-Pass Payments
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As physician practice leadership and financial teams plan for 2026, pressure to maximize reimbursement and minimize denials continues to rise. Yet the industry’s reliance on clean claims often drives perfection on misleading metrics rather than better payment outcomes. Most “clean claim” rates stop at clearinghouse acceptance—not payment. This session challenges the clean-claim myth and presents an outcomes-based approach that empowers teams to proactively improve reimbursement and strengthen financial health in the year ahead.
Learning Objectives:
By the end of this session, participants will be able to
- Differentiate acceptance-based clean claim metrics from payment-based metrics and understand which truly impact revenue.
- Evaluate current claim submission workflows to identify gaps and opportunities.
- Learn how to prioritize first-pass payment, reduce rework, and shorten days in A/R by aligning scrubbing to payment outcomes.
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Bronson Cox
COO, Encoda
Bronson Cox is the Chief Operating Officer and co-founder of Encoda, where he oversees product development and operations. With 25+ years in healthcare technology—including 18 years specializing in ANSI X12 EDI for medical claims and payments—he brings deep expertise across practice-management systems, software product development, and program leadership. For the past 14 years, Bronson has served on the ANSI X12 835 committee, advancing standards for payment posting and denial management. Earlier, he held executive roles at WebMD Practice Services and led Technology Services at Lee Data Systems (The Medical Manager, now part of Greenway Health).