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.

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