A Place at the National Podium

Emdeon’s Senior V.P. Miriam Paramore Addressed Delegates, Officials & Notable Guests, Shared in National Dialogue at a DNC Healthcare Reform Forum

Amidst the feverish excitement of the recent Democratic National Convention in Denver, Emdeon Business Services participated in an event—in a national dialogue, really—that soberly transcended party lines or affiliations to address a topic relevant to all Americans: healthcare reform.

The public Health Policy Forum, of which Emdeon was a corporate sponsor for an opening VIP reception, brought together a host of influential figures to discuss the present and future of our nation’s healthcare system. Emdeon’s Senior Vice President of Corporate Strategy, Miriam Paramore, herself a recognized thought leader in the industry, offered opening remarks for the reception, representing Emdeon in welcoming the likes of Congresswoman Allyson Schwartz, author of the E-MEDS Bill which requires e-prescribing for Medicare, columnist Arianna Huffington, and Kansas Governor Kathleen Sebelius.

“Emdeon is in the conversation,” Paramore says, recapping her experience at the event. “I’m thrilled to represent a company that’s doing the right thing...participating in the dialogue on the healthcare crisis that affects us all...to help in real, material way.”

Paramore came away energized not only by Emdeon’s role in the national discussion, but in how the company plays a substantive role in “moving the needle” by digitizing the industry and using information technology to turn raw data into usable information. Effective information exchange is essential to the functioning of the entire healthcare system, especially as that system is in a constant state of evolution.

“Our mission is to simplify the business of healthcare,” Paramore explains. “That’s why we are part of discussions on public policy and regulation, to stay on the forefront and influence direction changes that impact the electronic exchange of healthcare information. We are often the connecting point that keeps our customers prepared and ready. ”

Now more than ever, Emdeon is the “glue for the industry when changes occur that impact health information exchange.” By staying close to the regulatory machination, Emdeon is consistently ahead of the game, investing to accommodate altering governmental and industry standards/requirements long before business partners will be affected.

From pay-for-performance issues to handling unfunded mandates and quality initiatives, Emdeon aggressively seeks ways to use technology to make data accurate, expedient and readily accessible for payers, providers, and pharmacies. By improving eligibility transactions and applying business intelligence to EDI, Emdeon is helping reduce the $150 billion of inefficiencies related to insurance and billing activities that burden the healthcare system each year.

“Of course, this is our business, and our customers are our priority. Yet as we better serve our customers, we are improving the system as a whole. We’re motivated to step up our corporate responsibility to make a difference. We are not on the sidelines, in the quest for true reforms” Paramore summarizes. “We encourage our business partners to do the same.”

What does all this mean to you? Here are a few key ‘take aways’ Paramore shares with you from her DNC Health Reform Forum experience.

• Join the conversation. What individuals in your organization are committed to knowing issues, defining goals and finding solutions? Whether you begin simply by staying more informed or you choose to participate more prominently, you must be in the mix; your voice is vital to reform.

• Start your own conversation. Create ways to communicate with constituencies within your organization about key issues, to gain perspective from all angles. Start dialogue, and ensure communication is two-way so that questions, ideas and information can be shared effectively.

• You can count on Emdeon to help connect the dots. As you join in discussion and generate conversation from within, you can count on Emdeon to help filter and share information from throughout the industry. Connect with your Emdeon account manager and we will always do our best to accurately represent your ideas, questions and concerns to the associations and industry and governmental groups in which we participate.

From the Podium to Practical Application:
Because we’re as committed to taking action as we are to being part of the discussion, we’re launching the new Patient Responsibility Estimator. This exciting new tool enhances transparency of cost for patients who are increasingly responsible for paying for healthcare services. Learn more about the Patient Responsibility Estimator in the Beyond Price Transparency article of this newsletter.

Easing the Pain of Workers' Compensation Bills

Electronic transactions will save time, money and headaches

Throw away those paperclips, because soon Workers’ Compensation Bill and Bill Attachments will finally be able to be sent electronically!

On August 5th, 2008, Emdeon announced the launch of a new electronic solution for the filing of Workers’ Compensation, Auto Medical bills and simultaneous electronic submission of required documentation.

Once our new solution launches in Q4 2008, this new transmission solution will allow payers and providers to streamline submission and bill processing for jurisdictional ASC X 12N 837 Workers’ Compensation and Auto Medical bills. By enabling medical reports and documentation to be submitted electronically along with billing, our solution ensures compliance with new state eBill mandates. This solution will also eliminate the barriers that had previously complicated the acceptance of eBill traffic from healthcare claim subscribers, thereby helping deliver clean bills to carriers.

The Emdeon process for eBills will follow current providers and payer workflow for sending/receiving any other electronic claim, Group Health or Government claim. Using the State of Texas guidelines, the eBill submission is more in line with the Group Health HIPAA 837. The only significant differences are data content placement and the attachment process.

This Emdeon solution will be integrated into Emdeon Office and the Emdeon Vision Suite. You will be able send attachments by two methods: either upload an electronic attachment, or print a barcoded fax cover sheet. The bill and attachment will be processed and linked, then sent to the Workers’ Compensation payer. Providers will also receive claim status reports and ERAs.

We are excited about this new product because it will simplify your Workers’ Compensation bill and attachment processing. To learn more ways we’re Simplifying the Business of Healthcare contact us today 866.396.8805 or visit us online at emdeon.com .

Beyond Price Transparency

Price Transparency. These two health industry buzzwords convey the need to empower patients with simple and precise information about the cost of healthcare. Boiling down the complex healthcare pricing systems into patient-understandable terms prior to care is a critical step to enabling the patient to understand how much money they will owe after treatment and determining how they will pay their portion of financial responsibility. Furthermore, providing the costs of treatment prior to care gives the consumer an opportunity to shop for alternative care and figure out how their financial responsibility will be paid. While today’s patient financial responsibility estimation technology achieves price transparency by emulating the claim adjudication process, future enhancements will provide even more actionable information. Building on a foundation of treatment cost estimates, transparency also needs to incorporate facets of quality based on physician credentialing, patient safety, and healthcare outcomes. As these two components come together they will represent a fundamental driver to a successful consumer based market for healthcare.

In this evolved market, before seeing a primary care provider or a specialist, patients will be able to compare the credentials and quality metrics of providers in their area and across the country in conjunction with the price of their services. Credentials offer subjective evidence to understand the physician’s specialized training and to impart confidence in their ability to provide high-quality treatment by acknowledging where they were trained. Similarly, credentials will include board certification when a physician attains a higher degree of education and disciplinary actions when the physician is censured by an affiliated hospital, various medical boards, or indicted for criminal convictions. Information such as how many procedures of a given type the physician has performed will build on this theme of experience and add perspective to healthcare decision making. How much do you know about the physicians you see? Exposing physician credentials opens the door to information that will enable patients to compare quality.

Patient safety is another facet of quality transparency. Exposing comparable patient safety measurements will enable patients to understand the relative safety of one healthcare provider versus another. Imagine being able to compare the medication administration safety and infection rates of regional hospitals. Is the provider using Computerized Physician Order Entry to reduce the likelihood of prescribing errors? Does the nursing staff have access to systems that prevent medication administration errors? How many infections were caused in the last year within the hospital? Contrasting patient safety trends with those of similar providers provides information to the patient that has never been available before. Evaluating quality factors such as these increases transparency and helps patients assess where to get treatment.

New transparency tools will also enable patients to understand the outcomes expected with certain types of treatments and procedures. Outcomes will likely be demonstrated through standardized, evidence-based measurements and allow you to recognize the relative effectiveness of the types of treatments used by a particular physician. Instead of blindly accepting that a single clinical course of action exists for a given diagnosis, outcome comparison will demonstrate the comparative benefits of a treatment or procedure provided by one doctor versus the others available. The healthcare industry is dynamic and always striving for better quality, and making outcomes more transparent will spur competition leading the industry to even more breakthrough improvements.

Even after these quality transparency tools are readily available, price will very likely still play one of the largest factors. One hallmark of our society is that quality often costs more. A provider that develops strong credentials, keeps an excellent safety record, and achieves effective outcomes for patients will likely cost more than an average quality provider or one with a few blemishes on record. The ability to accurately estimate healthcare costs will be viewed in light of provider quality, and healthcare decisions will be able to undergo scrutiny with factual, comparative information. Providing transparent price and quality information prior to care will foster competition and lead to higher quality services at ever-competitive prices. As the healthcare industry continues to develop capabilities that enable more pre-care transparency, our aim should be far beyond displaying patient cost estimates and consider the quality aspect of the providers we pay.

A Faster and Easier Approach to Receiving Payments

Save time and money with electronic payments through Emdeon ePayment

One of the major concerns in today’s healthcare industry is finding ways to reduce costs and increase efficiency without sacrificing patient care. Emdeon Business Services now offers such a solution to providers with Emdeon ePayment, an electronic payment service that can simplify every payment you receive. Emdeon has always offered comprehensive programs that enable payers to efficiently distribute payments and remittance information to providers and consumers through electronic and paper methods. Now, we’ve made it even simpler. We recently introduced a comprehensive electronic payment solution that includes Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) with PDF versions of EOBs and postable files in an 835 format.

“Providers face highly fragmented processes associated with receiving and reconciling payments,” says Philip Hardin, Executive Vice President of Emdeon Business Services. “Additionally, the administrative costs and fees adds to the financial overhead of Providers, which Emdeon understands and is continuously working to minimize. Emdeon’s new electronic payment capabilities offer a smart solution that reduces costs for all the stakeholders.”

Emdeon provides payer remittance data electronically in the form of PDFs via Emdeon Payment Manager. This allows healthcare professionals to easily and efficiently reconcile the payments they receive from 3rd party payers right from their desktop.

“With Emdeon Payment Manager, staff can quickly search, view or print each remittance as needed,” says Hardin.“This reduces time spent resolving discrepancies and inaccuracies to allow you to focus more on your patients.”

Emdeon Payment Manager offers the ability to download Electronic Remittance Advices in 835 format directly into your Practice Management or Hospital Management Systems. Additionally, Payment Manager’s unique functionality allows you to upload ERAs received from other entities that are not processing through Emdeon. Robust reporting capabilities ensure that reconciliation, research and detailed follow-ups are streamlined and easily performed. Our Emdeon Electronic Payment offering also seamlessly integrates with our other leading edge solutions including AccuPost and the Clearinghouse.

Emdeon ePayment delivers valuable electronic payment and reconciliation processes to help providers like you eliminate paper checks, reduce costs and simplify secondary claims. This increase in efficiency saves time and allows many of your staff to focus on better ways to increase revenues. You will also benefit from the convenience of EFTs and faster access to reimbursements, while minimizing losses and reducing the costs associated with handling paper checks.

“The up-to-date payment information allows you to accurately get a pulse on your cash flow at any time,” says Hardin. “Since our innovative electronic payment service can connect to any EFT-enabled bank, you have the flexibility to choose the banking partnership that works best for you.” The Emdeon ePayment solutions are also unique as a result of Emdeon’s large base of payers already using electronic payments– over 670. Today, providers accepting EFT from payers typically are forced to accept different processes for each payer – resulting in multiple work flow variations. Emdeon brings a common solution across its payers, even for those payers that do not already support EFT. For those payers, Emdeon will take advantage of recent legislation, known as Check 21, that allows paper checks sent by payers to be electronically posted on behalf of providers and subsequently transmitted via EFT. In doing this Emdeon offers a truly universal solution that enables you to enroll once and receive electronic deposits for all payers currently in the program and as new payers come online.

“With simple enrollment, convenient delivery preference tools and a broad network of payers with single enrollment, this is something the company is excited to bring to the healthcare professional,” Hardin says. “This will allow you to accelerate and manage cash flow more efficiently with timely electronic deposits. Leave the worries of getting paid to us and instead focus on delivering quality care.”

Through our suite of provider solutions and robust payer connectivity, we uniquely offer the scale that both providers and payers need for a successful Electronic Payment implementation.

Don’t continue to accept paper when there is a proven solution in the market, already being used by your colleagues. Call us at 866.396.8805, or visit us online at www.emdeonepayment.com to learn more.

Business Objects and SAP Recognize Emdeon's Innovations

Industry leaders admire Emdeon’s compelling business intelligence innovations
Business Objects, an SAP company and the world’s leader in Business Intelligence software, recently honored Emdeon with its competitive Business Intelligence Excellence Award for 2008, recognizing both Emdeon’s IT department and infrastructure as innovative through its use of successful business intelligence strategies in creating Emdeon Vision. This coveted award acknowledges Emdeon’s enhanced database infrastructure as well as its use of BusinessObjects XI, Business Objects’ intelligence platform, to increase productivity by significant proportions.

The Challenge
Emdeon, the leading processor of healthcare transactions in the United States, issues up to 800,000 text-based reports per day to healthcare providers and payers. According to Gene Boerger, Vice President of Advanced Business Reporting, “If a claim is sent electronically, we send text-based reports back to the healthcare providers to track the claims into Emdeon, out to the insurance company, and back to the provider. Our experience is that these reports are very difficult for the providers to handle.”

The Solution
“With Crystal Reports as a key component, we’ve developed an electronic solution that allows us to distribute information much more quickly and efficiently….providers can immediately view the status of any electronic claim in the process,” describes Boerger. According to Business Objects, customer feedback credits Emdeon’s innovative solution for the “successful transition from paper-based reporting to a more efficient and cost-effective Web-based delivery.”

Emdeon Customers Agree
MedePresence CEO Dave Dugan concurs: “Emdeon Vision will definitely drive down errors, while accelerating and automating support for us as your channel partner. Keep up the awesome work!” According to Boerger, “Our business is about making sure that electronic healthcare transactions are delivered quickly and accurately, and that the responses are returned in a timely manner to the customers who need them.”

Simplifying the Business of Healthcare
“Using BusinessObjects, we’re able to deliver the data multiple ways to multiple customers with multiple security models – quickly and effectively. This enables us to focus on the organization of the information itself, which is a much smarter use of our resources,” explains Boerger of this innovative solution. “Whether it’s medical claims, dental claims, electronic remittances, real-time insurance eligibility requests, or Health Insurance Portability and Accountability Act (HIPAA)-based transaction sets, Emdeon Vision makes life easier for payers and providers alike,” writes Business Objects.

To learn more about Emdeon’s Business Intelligence Excellence Award and how Emdeon can simplify your healthcare business, call us today at 877.EMDEON.6 (877.363.3666) or visit us online at www.emdeon.com.

New Payers on Board

New payers added this quarter

Emdeon Business Services is pleased to announce the following
payers as part of our constantly expanding network:

• Advantage by Bridgeway Health Solutions - Claims
• Arkansas Managed Care Organization Inc - Claims
• Berkshire Lehigh Partners - Claims
• CM Administrators Inc - Claims
• Citrus Health - Claims
• SC Medicare Part A & SW/SE - ERA


For a complete list of the payers in our network, visit our website.

Key Department Phone Numbers

A New Healthcare Model?

A closer look at universal healthcare

While many Americans understand the basic economics of our existing healthcare system, healthcare reform is front-and-center in the 2008 election cycle. One of the most discussed and dramatic changes being proposed is universal healthcare. Once viewed as impossible, universal healthcare now seems more possible than ever. Consider that Massachusetts, California, Maine, Vermont and Hawaii have created, or are currently considering implementing, universal or near-universal systems.

While many Americans understand the market-based model, universal healthcare is a very nebulous and undefined idea in the American political discussion. This leaves many of us asking: What is universal healthcare and what does it mean for the modern healthcare industry?

Coverage for all citizens

Whether one calls it universal healthcare or universal coverage, the goal is the same: to extend healthcare coverage to every citizen by either private insurance or government programs. Beyond that common goal, proponents often vary greatly on how to achieve it.

Understanding the differences between the primary methods of implementation around the world is the key to assessing what effect any such healthcare reform will have on patients, providers and payers in the US.

What are the most common forms of universal healthcare?

Compulsory Insurance - Currently used in Massachusetts, Germany and Belgium

The compulsory insurance model uses legislation to require every citizen to purchase affordable health insurance. A government oversight board creates the definition of affordable after negotiating with pharmaceutical and insurance companies to mediate their potential liability. In the Massachusetts model, which took effect in 2006, citizens who do not qualify for poverty/low-income assistance must buy insurance or face yearly fines assessed on their income tax. Legislation also expands coverage for the poor and penalizes employers who do not offer healthcare coverage.

Taxation - Currently used in England, Australia and India

Taxation is a very different way to achieve universal healthcare. In this model, which has been used in England since the end of World War II, insurance is almost entirely eliminated and the healthcare system is regulated by the government and funded from the public tax pool. Hospitals and high-level healthcare infrastructure are overseen by government agencies, while doctors and staff are a mixture of private and government employees. Some countries have also used the taxation model, but left direct control up to state or provincial governments.

Combined - Currently used in Canada, Singapore and the Netherlands

Several countries have taken this dual-level approach to universal healthcare wherein primary care is directly funded by tax dollars collect from the general public. Private insurance companies still exist to offer supplemental coverage for extra services like dental, vision, elective procedures, extended hospital stay, upgraded facilities for hospital stays and other services deemed outside of primary care. Often, such as in Canada, almost all hospitals are publicly managed. The amount of public and private mixture varies between each version implemented by a nation or state.

The reforms to the healthcare industry discussed during this election cycle are sure to be as complex and difficult as the problems facing our industry in general. Whether any politician in America rallies enough public and political support to implement a universal healthcare system, there is an undeniable urge on all sides to change the business of healthcare for the better. Everyone agrees that increasing efficiency, reducing costs and improving overall care are of vital importance to any plan, but how we achieve those goals, it appears, will remain open to debate.

Efficient Healthcare Collections – Back Office to Front Office

...Uncollected receivables related to CDHP are forecasted to reach $38B in 2008 growing to $82B in 2012
...$0.38 of every physician dollar is related to bad debt
...Approximately 12% of healthcare spend is the patient’s responsibility and growing*

What is the impact of these trends to the provider?

Increased patient co-pays, coinsurance and deductibles both for traditional insurance plans and consumer driven health plans resulting in increased provider administrative cost to collect based on current payment collection processes.

The increasing shift of financial responsibility from employer and health plan to patients requires providers to manage their accounts receivable more efficiently. Providers can no longer rely solely on current back end billing processes and on private insurance or government programs for the bulk of the health service payments. Providers need to implement ways to identify patient responsibility prior to, or at the point of, service and begin to stave off the increasing administrative cost related to collecting patient payments.

The patient landscape is also fast evolving to where the member is not just a patient but is a retail consumer. As with any retail environment, consumers are beginning to shop around for services. In order to maintain a competitive edge and ensure streamlined administrative costs, providers need to provide an efficient solution for cost and quality transparency of their services.

Providers are starting to implement ways to identify patient responsibility prior to the patient leaving the office and are beginning to ensure the patient has a true understanding of their financial obligations at the time of service. Several industry solutions offer providers the ability to estimate patient cost of service delivered – either before or at the point of service, based on a combination of provider historical paid claims data, provider contract rates with payers, patient benefit information or fee schedules. Adopting these solutions gives the provider the ability to understand patient responsibility and set the expectation with the patient for payment. The impetus for the payment assurance solutions in the industry is to enable and empower the provider with patient responsibility data, as well as to enable the provider to understand the patient’s ability to pay and to complete the cycle by enabling the patient collection. All of this can be accomplished with decreased administrative burden to collect payment.

Research has shown that if a patient expects and understands their responsibility, they are more likely to make plans to pay for the service; and a provider’s chances of getting the patient payment is highest when they present it to the patient at point of service so a payment plan can be setup prior to a patient leaving the office.

Patient responsibility and financial liability solutions will not only increase upfront collections, but it can also directly impact the ability to collect efficiently post-discharge, including how to direct outsourced collections efforts. In addition, it can also streamline efforts to qualify patients for charity care and government programs and ensure that charity practices are implemented consistently. For everyone's benefit, patients who qualify for charity discount programs can be enrolled in them right away, on the front end, saving both parties time and money.

Point of Service collection encounters can be successful even if you don’t get a dollar, as long as the patient walks away from the office understanding why he or she owes the $200 and thinking about how to pay it. At this particular juncture in the consumerism movement, educating the customers of their financial responsibility is just as important.

Provider offices must be prepared not just to deliver accurate and timely information about a consumer/patient’s benefits on the spot, but also to explain that information in terms that make sense to the consumer, to listen to the consumer’s response and react appropriately, and then to bring the conversation to a close in that satisfies both parties.

Patients are beginning to carry the majority of uncompensated care, yet most provider offices lack the necessary tools and technology to optimize patient collections, or to ensure that charity care and public assistance patients don’t fall through the cracks. With the increasing number of patient out of pocket payments, providers will need to adopt solutions to better understand patient responsibility and begin to have the conversations with patients about their out of pocket costs and payment plans in order to maintain a viable revenue cycle.

*Source: March 2007 Kaiser Commission on Medicaid and the Uninsured & Forrester March 7, 2005 report on Will Health Plans profit from HSAs; nTelagent April 2008 report

It's Almost Payment Time... Do You Know Where Your Claims Are?

Improve claim visibility with Emdeon Vision^SM for Claim Management

Determining the status of your claims once they have been submitted has always been a painful and time consuming process, but with Emdeon Vision for Claim Management providers can track any claim on the largest network in healthcare, all from one place. This powerful web-based application gives providers a simplified, end-to-end view into the claim cycle through one secure system.

Clear and concise monitoring

With Emdeon Vision for Claim Management, once the claim has been submitted you will be able to monitor its progress through centralized and easy-to-read claim summaries. This will replace the need to call multiple payers and visit multiple websites to get updated claim statuses. These summaries allow you to quickly scan all claims and focus staff attention on ones that require further work, then sort and search claims according to a variety of different elements. Having the ability to quickly rework the claim also helps reduce or eliminate painful delays in your cash flow. Since all searches are done electronically, you will no longer need to worry about patients in your office overhearing the sensitive information that is sometimes exchanged over the phone.

Reduce rejections and delays

Every provider has to deal with some level of claim rejections, but with Emdeon Vision for Claim Management you will be able to view and take corrective action on incorrect codes that can save weeks over manual processes. You can also expect to get accurate and detailed monitoring thanks to intuitive reports. The reports can quickly reveal important trends like where your claims are being delayed, and you'll get them in consistent formats to eliminate the labor-intensive task of monitoring paper claims. Spotting trends in rejections can also lead to higher first-pass acceptance rates and save you even more time and money.

Emdeon Vision for Claim Management combines all of these valuable features into one easy-to-use and centralized solution that greatly increases your ability to see what's happening with your claims almost as it happens. You will have the same great insight and monitoring capabilities as the nation's leading payer groups, which improves your ability to predict and manage cash flow while focusing more on the cornerstone of your healthcare business: your patients.

To find out more about how we can improve your claim management, contact us today at 866.558.3581 or contact us online.

Physician's Corner

Answers to questions submitted from some of our physician readers

How do I enroll with a payer for electronic funds transfers (EFT) or electronic remittance advice (ERA)?

Medicare: All Medicare payers offer an EFT solution. To get paid electronically for government-related claims, download and fill out the CMS588 form from the CMS website. Mail the form, with the original signature (no facsimile signatures can be accepted), to the Medicare contractor that services your geographical area.

For additional information, on the use of EFT for provider payments, refer to the Medicare Claims Processing Manual, (Pub. 100-04), Chapter 24, Section 40.7.

Medicaid: To sign up for EFT, go to your state Medicaid website and research to see who state Medicaid processor is. Each state website will have their enrollment instructions and process posted.

Blue Cross Blue Shield All Blues plans have enrollment instructions on their individual websites.

Commercial: Each Commercial payer that offers an EFT solution has their own enrollment process. You will need to contact the payer directly to inquire about their specific EFT process and availability.

If you have a question you would like answered in our next newsletter, please submit your question to contact@emdeon.com.

New Payers on Board

New payers added this quarter

Emdeon Business Services is pleased to announce the following
payers as part of our constantly expanding network:

• Advantage by Bridgeway Health Solutions - Claims
• Advantage by Buckeye Community Health Plan - Claims
• Advantage by Managed Health Services - Claims
• Advantage by Superior HealthPlan - Claims
• Aequitas Capital Management - Claims
• American Benefit Plan Administrators - Claims
• AmeriChoice by UnitedHealthcare-New York - ERA
• AmeriChoice of New Jersey, Inc. (Medicaid NJ) - Claims
• Banner Health - Claims
• BCBS Utah FEP - Claims
• Beacon Health Strategies - Claims
• Blue Cross Blue Shield - Montana - ERA
• Blue Cross Blue Shield of Montana - ERA
• Blue Shield Washington - Claims
• Care To Care - Claims
• Cedars-Sinai Medical Network Services - Claims
• Central SeniorCare - Claims
• Custom Design Benefits Inc. - Claims
• Dept. of Human Services - ERA
• Eastland Medical Group - Claims
• EDS - ERA
• Elder HLTH Maryland - Claims
• Fidelis Secure Care - Claims
• First Priority - ERA
• Global Care Inc. - Claims
• Health Systems International - ECOH - Claims
• Healthcare Resources NW - Claims
• HealthPartners - Claims
• HIP - Health Insurance Plan of Greater New York - ERA
• Independence Administrators - Claims
• InterCare Health Plans Inc. - Claims
• International Educational Exchange Services, Inc. (IEES) - Claims
• Johns Hopkins Healthcare (USFHP) - ERA
• Kaiser PPO - Claims
• Korean American Medical Group - Claims
• Manatee Service Center (Bradenton, FL) - Claims
• MedDirect - Claims
• Medicare Regional Home Health & Hospice - Golf Coast & Mid West - Claims
• New Century Health - Vista Cardiology - Claims
• Noridian Medicare - ERA
• Optima Health Plan - Claims
• Optima Insurance Company - Claims
• Partnership Health of California-CAPHP - ERA
• Piedmont Behavioral Health - Claims
• Pittman & Associates - ERA
• Progressive Benefit Services, Inc. - Claims
• Riverside San Bernardino County Indian Health Inc. - Claims
• Rwdsu Benefit Fund - Claims
• SelectCare of Texas (HPN) Heritage Physicians Network - Claims
• Sentara Family Care - Claims
• Sentara Health Management - Claims
• Southern Cal Physicians Managed Care Services - Claims
• Stones River Regional IPA- Windsor - Claims
• Texas Children’s HEALTH - Claims
• TrailBlazer Health Enterprises - Claims
• UAHC Health Plan of Tennessee - Claims
• Ucare Minnesota - Claims
• United AmeriChoice of Wisconsin - ERA
• United Healthcare of River Valley - ERA
• United Healthcare of the Mid-Atlantic, Inc. - ERA
• United Medical Resources - ERA
• Universal Health Care, Inc - ERA
• Value Options PA - Claims
• Verdugo Hills Medical Group - Claims
• Viva Health Plan - Claims
• VNS Choice Medicare - Claims
• WellPath - Claims
• West Corvina Medical Group - Claims
• WestLake Financial Group, Inc. - Claims
• WPP-ElderCare Wisconsin - Claims

For a complete list of the payers in our network, visit our website.

Key Department Phone Numbers

Ever Dream About What You'd Do with an Extra $42,000? Maybe Travel the World?

The Savings to Make it Happen.
A recent Milliman study* reported that the average physician could save $42,000 by automating eligibility and claims processing. By automating these key reimbursement cycle steps with Emdeon Office, providers can do far more than just save money: our solutions work together to increase up-front collections and reduce errors to increase first-pass acceptance rates. We can help you automate your more time-consuming manual processes to help you realize savings.

All Payers. One Login.
Emdeon Office connects providers to the largest, most trusted network of payers in the industry for key claim management tasks and eligibility checks in real-time. While payer websites might seem free, managing the numerous usernames, passwords and web addresses can be inefficient and cost you more than you think. Emdeon Office eliminates wasted time by giving you access to real-time information from all of your payers through one page with one username and password. We combine the information and benefits from the numerous payer websites into one simple, secure portal.

One Solution. Low Cost.
In addition to getting all of your eligibility information in one place, Emdeon Office is the key to helping improve first-pass acceptance rates, accelerate reimbursements and conduct real-time pre-certifications. No matter how you look at it, Emdeon Office is the low-cost, web-based solution that connects you to the most payers available in the industry.

For very little investment you can automate so many key parts of your reimbursement and payment processes, you’ll know things are running smoothly back at the office when they stamp your passport!

Ready to stop dreaming and start saving for what you really want to do? Learn more about how we're Simplifying the Business of Healthcare by calling us at 866.558.3581 or contact us online.

*Source of cost and savings data: Milliman. Electronic Transaction Savings Opportunities For Physician Practices, 2006. To read the full Milliman study.

Is Your Office Ready For Healthcare Consumerism? Be Ready to Adapt and Succeed!

Healthcare Reform is Coming
The National Coalition on Health Care* reports that current spending trends show that by 2050 the federal government will have to spend $14 trillion to keep Medicare and Medicaid afloat. You don’t have to be a whiz at international economics to realize that amount of spending is impossible to keep up year after year. The common assumption is that the government will have to reduce eligibility and benefits for these programs and more of the financial burden will fall on the patients.

Historically, the patient billing and payment process has been composed of fragmented steps that relied on disjointed solutions. However, with Emdeon Patient Connect, providers can enjoy an integrated and bundled solution that can help save time and money at every step. Our solutions work together to help make every aspect of your billing and payment cycle quicker, easier and more efficient.

What Does this Mean for You?
The trend toward greater patient responsibility makes it increasingly important for providers to seek solutions that can give them specifics about patient benefits, co-pays and ultimately estimating in advance what the financial responsibility will be after the delivery of care. The ability to give patients accurate, up-front financial information will help them plan for what’s coming and help alleviate concerns about overcharging and unfair billing practices. As the market changes, Emdeon is here to provide you with the intelligent and innovative solutions you need to succeed. Here’s what Emdeon Business Services CEO George Lazenby had to say about what we’re doing to stay in-front of these market changes:

“Emdeon has always been a leader in helping providers determine patient benefits at the point of care. Our eligibility solutions lead the market in terms of payer access and utilization. As benefit plans change and more patients select high deductible and consumer-driven health plans, we recognize the financial pressure that will be put on providers. In response to this change in the market, Emdeon has developed a set of next generation tools that will allow providers to more accurately assess a patient’s true benefits, determine their likelihood of payment and deliver an estimate to assist in patient collections at the point of care. Emdeon remains committed to evolving its solutions to address the growing and ever-changing challenges providers face in their revenue cycle.”

As the patients begin to look at healthcare with the concerns of a consumer, Emdeon is ready to empower you with the unmatched solutions and expertise you need to thrive. Contact us today and learn how we can Simplify the Business of Healthcare for you.

To discover more about how we can help, contact us today at 866.558.3581 or contact us online.

*Source of budget projection: National Coalition on Health Care: Impact of Rising Health Care Costs on the Economy.

Don't Miss the Next NPI Deadline!

Stay on Top of Important National Provider Identifier (NPI) Requirements

In our industry, the standards, rules and regulations are constantly in flux. How can a busy healthcare provider keep up with the changes? Providers can rely on Emdeon to help clear through the clutter and stay on top of the latest requirements. The quickly approaching deadline to transition to NPI is an ideal example.

On May 23, 2008, all providers will be required to use their unique NPI on all HIPAA-covered transactions. To ensure a smooth transition, make sure you find out which payers require you to register your particular NPI before you begin attaching it to your sent claims.

Since May 2005, when The Centers for Medicare and Medicaid Services (CMS) announced the adoption of the NPI as the new means of identifying healthcare providers in healthcare transactions, Emdeon has been busy making sure its products are NPI compliant. We’re still working today to make the transition to NPI as seamless and simple as possible for your healthcare business. Specifically for Emdeon Office customers, we have the ability to support NPI for those who may not be able to send the NPI on their claim file.

To discover more about what we can do to help you simplify your NPI adoption, call us today at 866.558.3581 or contact us online.




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Don't Be the Last to Upgrade!

Update your POS Device's Fashion and Functionality with Emdeon

Keeping track of coverage eligibility for your patients who are enrolled in one type of healthcare plan or another can be difficult and time-consuming. Additionally, the more plans in which your practice participates, the bigger the problem is for you or your staff. Conversely, every time a payer rejects a claim, your practice is not only inconvenienced, but also short-changed. Inadequate patient verification creates delays in payments that harm your practice’s cash flow.

What if you could access all the payers you needed for patient eligibility verifications? What if new payers were automatically added to your device? Emdeon Business Services has introduced a state-of-the-art Point-of-Service (POS) terminal that will make eligibility checks a breeze!

The stylish and compact Vx570 POS machine enables users to submit eligibility and benefits transactions to any real-time government and commercial payer in the Emdeon network. The Vx570 increases standard POS performance by offering maximum flexibility and superior speed, creating the most advanced POS processing unit to date.

The Emdeon POS terminals are easy to use for patient eligibility verification and are ideal for front-end locations, such as registration areas or other areas where space is a consideration. With the new POS terminal, you can verify eligibility for Medicaid, Medicare and numerous commercial insurance plans. You can verify eligibility in seconds, receive a printed record of the response and have a quick, simple, and accurate way of classifying patients during normal registration.

And, it’s at a price that makes upgrading an easy decision!

For more information on how our newest POS device can help your healthcare business, call us today at 866.558.3581 or contact us online.

New Payers Launched

Emdeon Business Services Expands Its Reach

Emdeon Business Services is pleased to announce the following
payers as part of our constantly expanding network:

• Advantage Preferred Plus - Claims
• Aetna - Rosters
• Aetna TX Medicaid & CHIP - Claims
• BC Indigent - Claims
• BC of Washington (Premera) - Eligibility
• BCBS Colorado - Eligibility
• BCBS Connecticut - Eligibility
• BCBS Iowa - Wellmark - Claims
• BCBS Kentucky - Eligibility
• BCBS Maine - Eligibility
• BCBS Nevada - Eligibility
• BCBS New Hampshire - Eligibility
• BCBS of Alaska (Premera) - Eligibility
• BCBS of Arkansas - Claim Status
• BCBS of North Carolina - Eligibility
• BCBS Ohio - Eligibility
• BCBS South Dakota - Wellmark - Claims
• BCBS Virginia - Eligibility
• Benefit Management Systems, Inc - Claims
• Blue Cross and Blue Shield of Michigan - Claims
• Blue Cross Blue Shield of Kansas - ERA
• Blue Cross Delaware - Claims
• Bravo Health Inc - Eligibility
• CHC Cares of South Carolina - Claims & ERA
• GHI - Medicare Private Fee for Service - Claims
• GHI - New York (Group Health Inc.) - ERA
• Health Market Care Assured - Claims
• Healthchoice of AZ - Claims
• Healthfirst New Jersey - Eligibility & Claim Status
• HIP Health Plan of New York - Eligibility
• Keystone Health Plan East - ERA
• OSNA Cigna Commercial - Claims
• OSNA Cigna Medicare - Claims
• OSNA United Health Care - Claims
• Passport Health Plan - Eligibility
• Pittman & Associates - Eligibility & Claim Status
• VYTRA - Eligibility
• WellPath - Claims

For a complete list of the payers in our network, visit our website.

Spotlight on Supplies

Do you use stationery and forms with your practice’s name on it? Have you ever given away items with your logo to promote the name of your practice? Did you know Emdeon can help you with that?

Emdeon Office Supplies distributes to the marketplace the solutions and products your practice needs, from customized promotional giveaways to everyday office materials. Emdeon Office Supplies is your source for:

Filing and Chart Management: All the products you need to keep your patient charts organized in preparation for the electronic medical record, including folders, divider labels and supporting products.

Code Books: CPT, ICD-9, HCPCS, CDT, physicians desk reference, compliance manuals, coding guides by specialty and others.

Office Furniture, Shelving & Cabinets: Reception area chairs and furniture, modular desk units, file storage cabinets and movable storage systems.

Patient Relations: Office brochures, treatment/care instructions, newsletters, announcements, education material, business and appointment cards.

Envelopes: Business, professional, billing and insurance .

Forms: Clinical health information records, laser statements, checks, custom forms and stock forms.

Over 20,000 office supply items to help keep your practice running smoothly! For a complete listing of our office supplies, visit our website.