Powerful Platform Starts—and Closes—the Loop for Busy Practices
Emdeon just added more spin to the revenue cycle with the launch of the new Emdeon Office Suite.
This progressive product now offers integrated innovations that work intuitively with all administrative tasks—from patient access to payment. Long known as the go-to for eligibility and claims support, today’s Emdeon Office Suite provides a complete suite of solutions, and the outcome is a smooth end-to-end workflow for busy practices like yours.
In practical application, Emdeon Office Suite provides superior functionality for all the in-between tasks that are core to running a professional practice. And because these tasks are integrated into a unified suite that’s designed to seamlessly share data, everything works together simply and reliably.
Available through the NEW Emdeon Office Suite:
Real-time Eligibility and Benefits Verification
Eligibility and benefits verification helps to simplify and streamline patient access. Emdeon is connected to the largest group of commercial and government payers in the industry through which accurate eligibility information can be verified in real-time or high-volume batches and easy-to-read benefits statements enable you to see an estimate of what your patients will owe at check-in.
Complete Claim Management
Submitting claims, including Workers’ Compensation eBills and Automobile Medical electronic bills and attachments is quick and easy with direct data entry and batch upload options from any practice management system. Our innovative, award-winning reporting and analytics tools give you complete visibility and tracking capabilities from the point of claim submission through payment so you can see where your revenue is anytime during the claim lifecycle and the mobile version enables you to see where your money is on your iPhone®, Android(TM), Windows Mobile(TM), Palm® or other “smart” portable device anytime, anywhere.
Point of Service Payment
Emdeon Office Suite securely accommodates debit and credit card payments to bolster payment collections, particularly at the point of service. Upfront payment significantly helps to shorten the cycle and close the loop for provider compensation.
Powerful Payment Management Tools
Revenue and profit are the lifeblood of any business and Emdeon payment tools can help you increase both, while improving efficiency. Emdeon Office Suite delivers valuable electronic payment and reconciliation processes that help providers eliminate paper checks and simplify secondary claims. As a result it can dramatically reduce expenses, shorten the reimbursement cycle and streamline workflow. By increasing efficiency it creates time for providers and staff to focus on reconciling outstanding payment issues to capture otherwise lost revenue.
Single Click Statements
New to Emdeon Office Suite, the patient statements option provides one-click access to fast, accurate statement processing and dissemination. This affordable service is integrated to immediately accept transmitted billing information and promptly process, print and mail statements and invoices. This reduces the time and effort involved in traditional billing methods, shortening the cycle of compensation.
Clinical Tools
The updated suite includes a handy Clinical Tools tab that represents the future integration with Emdeon Clinician, an EMR Lite solution with leading Health Information Exchange. Our EMR Lite consolidates electronic prescribing and lab ordering, as well as results distribution. These clinical tools work in concert with all office functions and importantly, they also aid in helping providers meet Meaningful Use criteria and, thus, qualify for stimulus incentives.
Ceaseless Support
Emdeon Office Suite is supported by the always-open-for-business Emdeon ON24/7. This user-focused solution not only provides call-in support, it accepts request submissions online anytime so that those needing assistance aren’t funneled into a maze of phone calls, hold messages and automated systems. Requests are received and processed immediately and answered efficiently.
Finally, a new user interface enhances the suite life with a modernized look and easy navigation. With intuitive operation and quick access to the tools used most often, the Emdeon Office Suite is simple to learn for all staff members. It easily integrates into day-to-day office activities—providing end-to-end solutions and closing the loop on revenue cycle management.
Check out the NEW Emdeon Office Suite! 
Emdeon Office Suite: start with the end-to-end solution in mind
Anatomy of a patient-friendly bill
Practical Lessons in Success from Seattle’s Northwest Hospital & Medical Center
“Patients need clear, understandable statements...sent out in a timely fashion. It has made a huge difference for us.”
To hear Janet Walthew discuss the topic, it seems so simple. You see, Walthew is the Director of Patient Financial Services at Seattle’s Northwest Hospital & Medical Center, an organization that has successfully transitioned to a patient-friendly billing model. Walthew and Revenue Cycle Senior Director, Mike Smith, led Northwest Hospital’s shift from an approach focused on major payers to a system keenly in tune with today’s patient-consumers.
So—just what did Walthew, Smith and the Northwest Hospital team do? They leveraged industry best-practices, consulted patients and found a new billing partner in order to create clear and concise financial communications.
Keeping the patient-friendly billing standards outlined by the Healthcare Financial Management Association (HFMA) in mind, the hospital designed several sample statements and surveyed patients to better understand which format most clearly communicated the information. Based on their input, the statement format was finalized.
The next step for Northwest Hospital was to find a partner who could implement its customized patient statement. This was not an easy task.
In the past, patient statements were relatively easy to produce since most of the information was pulled directly from one data file. To present the information in a more patient-friendly manner, the new statement required complex information processing – pulling data from six files and summarizing the content as needed. After contacting eight companies about printing and mailing the new statements, only Emdeon was able to comply with the requested design and manage the complex web of reporting required to generate the patient statements.
When the new statement was introduced, Northwest Hospital helped current account holders understand their new bill by providing a patient statement guide. This reference tool included an image of a sample statement with call-outs to identify the most important pieces of information on statements.
Since Northwest Hospital implemented a more succinct, plainly stated and well-designed patient statement, the hospital has enjoyed improved receivables, reduced volumes of patient inquiries—and a much healthier revenue cycle all around.
Below includes a list of the patient statement best-practices that Northwest Hospital implemented in order to become a patient friendly billing institution. How does your current statement compare?
a. Use unique fonts, color and capitalization for section headers.
On Northwest Hospital’s past statement layout, it was hard to quickly find information since section headers were the same font size as variable data. Northwest Hospital’s new statement features headers in a green font nearly two times larger than the black variable text. This helps patients visually categorize information and follow content easily.
b. Organize content in a logical order.
A glance at Northwest Hospital’s past bill could be overwhelming, as it contained minimal financial summaries and presented the information in a letter format. In contrast, the new layout eases customers into the details– beginning with basic account identifiers, to a summary of charges, then a detailed listing of itemized charges, ending with the patient’s outstanding balance.
c. Communicate that the insurance claim has been processed.
This clearly communicates that the insurance company has successfully processed the claim and the amount due listed on the statement is truly the patient’s responsibility to now pay.
d. Provide a summary of services and a subtotal of charges.
Northwest Hospital’s new bill includes a “Patient Services Provided” section on the left side of the statement that provides a general summary of charges such as “Pharmacy” and “Room Charges” along with subtotals for each.
e. Separate more detailed information from overview sections.
Northwest Hospital created a separate “Account Information” section located on the right side of the statement that provides more specific information. This section starts with the top-line charges (total from “Patient Services Provided”) minus insurance and patient payments previously applied. Finally, the remaining patient balance is listed.
f. Visually call out the amount you are requesting the patient to pay.
Northwest Hospital’s bill makes the “amount due” hard to miss. The bottom portion of the bill is green with a white call-out box reserved for this all-important total.
g. Use a call to action when highlighting the amount to be paid.
Previously, Northwest Hospital’s patient bill stated “Total Amount Due”. While accurate, this does not give instruction to patients about what to do with this information. On Northwest Hospital’s new bill, “Please Pay This Amount” clearly communicates what patients need to do.
h. Include a “Contact Us” section.
Clearly communicate all of the options available (by phone, by email, online, etc.) and provide your customer service hours of operation.
i. Give simple, quick alternatives to pay.
Northwest Hospital added a credit card payment form at the top of the patient statement that is pre-populated with customer information. Patients only need to add their credit card information and mail the payment stub to complete the transaction.
Pay-by-phone and internet based payment options with directions were also added to the patient statement to encourage the use of automated payment collection.
Emdeon is the leading provider of integrated Patient Billing & Payment Solutions that help healthcare professionals, like Smith and Walthew at Northwest Hospital, optimize their cash flow management while reducing administrative costs. Patients Statements are now available through Emdeon Office Suite. To discover how you can easily and affordably send your patient statements call 866.369.8805 or visit our enrollment site.
Customize statements with your preferred format and colors 
U.S. Healthcare Efficiency Index Advisory Council issues national progress report on healthcare efficiency
For more than a year, the Advisory Council for the U.S. Healthcare Efficiency Index® (USHEI) has asked the healthcare industry, "What would you do with $30 Billion?" as a way to raise awareness of the potential savings from the administrative side of healthcare.
Today, the USHEI Advisory Council released new findings that suggest the needle is starting to move more rapidly on electronic adoption though there is still much work to be done. The USHEI National Progress Report on Healthcare Efficiency suggests continued progress on the adoption of electronic medical claims which, according to the sample cited in the report, are being transmitted at a current rate of 85%, which is a 10% increase over the USHEI Phase 1 findings released in December 2008. Likewise, adoption of electronic remittance advice transactions stands at 46%, which is significantly higher than the 26% estimate from Phase 1.
The USHEI is an industry forum for monitoring business efficiency in healthcare and tracking the transition from a paper- and phone-based healthcare system to an electronic one. It is governed by an independent Advisory Council responsible for overseeing the effort, developing the data collection methodology and reporting on progress across the healthcare industry.
The administrative simplification provisions of the recently signed healthcare reform law call for additional electronic business transactions, such as electronic funds transfer (EFT) payments, to be adopted by the industry. The new law also requires more uniform standards and a set of operating rules for all covered electronic transactions. The USHEI will continue to serve as a central reference for tracking progress and the cost savings associated with electronic adoption, including the transactions called for by the healthcare reform law.
"The report will show you how we are working as one interdisciplinary team focused on one big goal," said USHEI Advisory Council member Jane Sarasohn-Kahn of THINK-Health. "Along the journey toward efficiency, Americans will realize improved convenience, quality and cost-savings. And they'll get the sort of health system they expect as modern, online tax-paying, bill-paying, healthcare consumers."
The USHEI National Progress Report on Healthcare Efficiency represents a snapshot of the progress of the USHEI. Phase 1, launched by Emdeon (NYSE: EM) in December 2008, focused on analyzing industry data available through research reports and other sources. Phase 1 included five basic medical claims-related transactions: Claims Submission, Eligibility Verification, Claim Status, Claim Payment and Remittance Advice.
Phase 2, launched last summer, marked the beginning of primary data collection with major healthcare payers. To facilitate the data collection process, the USHEI team spent several months developing its National Data Collection Center which allowed participants to self-report transaction data through a secure, password protected web portal. Non-identifiable data was sent to statisticians at Scheuren– Ruffner, where it was aggregated and analyzed. The USHEI Advisory Council, under the guidance of the statisticians, worked to develop a data collection methodology which would then be tested using a smaller sample of payers and transactions. Once the analysis is completed on the smaller sample, outreach will begin to the entire payer community to complete data collection and analysis on the remaining transactions.
Today's initial findings are based on data gathered from an initial sample of 113 payers that includes two large national payers and over 100 medium and small regional payers. This data sample is estimated to represent approximately 122 million covered lives or about 40 percent of the U.S. population.
Key findings discussed in the USHEI National Progress Report on Healthcare Efficiency include:
Continued progress on adoption of electronic medical claims. The data shows a current electronic rate of 85% which represents a 10% increase over the Phase 1 findings.
Adoption of electronic remittance advice transactions is also higher. The data shows a current electronic rate of 46% as compared to 26% in Phase 1.
Continuum of Automation: Calculating the cost differences between manual and electronic healthcare transactions is becoming more complex. Rarely is a provider practice purely manual or purely electronic, and a provider's place along the continuum can vary. Stakeholders must understand all the components of healthcare transactions to remove costs and enhance the value of those transactions.
System level cost reduction. Approaching the systemic inefficiencies in healthcare to decrease overall costs is critical to help avoid the continual cost shift among healthcare industry stakeholders that has plagued healthcare for so long.
Clinical and Administrative Convergence. "Meaningful Use" requirements are expected to drive further adoption of electronic claims and eligibility transactions. The inclusion of these administrative transactions as a part of "Meaningful Use" reflects the ongoing convergence of clinical and financial information, which is an important trend in the evolution of health information exchange.
Pragmatic Solutions. Federal healthcare reform provisions enacted this year include some administrative simplification elements, such as a mandate for electronic funds transfer payments. These practical provisions enjoy broad bipartisan support and were scored favorably as "pay-fors" by the Congressional Budget Office.
Reporting. Automating basic administrative transactions and measuring progress on adoption can be an important and impactful first step to real cost savings.
Change is hard. But for the nation's healthcare system, not changing will be much harder. With Medicare Trust Fund Reserves expected to be exhausted by 2017 and 41 states currently facing mid-year budget shortfalls, it is critical to capture tangible savings today wherever possible.
While work continues to expand the data set and analysis, the initial findings in the USHEI National Progress Report provide a new baseline for tracking progress and validation of the data collection methodology. This methodology can now be scaled for a more complete set of payers and then beyond to other healthcare stakeholders.
Plans are already underway for later phases of the USHEI, including development of a Pharmacy Efficiency and Adherence Index.
"Monitoring the progress of healthcare efficiency through channels like the National Progress Report only stands to increase awareness of this vitally important issue," said Miriam Paramore, Emdeon senior vice president of corporate strategy and government services. "Today's report shows that electronic adoption in healthcare is trending upward, but opportunities for significant cost savings still exist. As we move towards a more efficient healthcare system, it will take everyone in the industry working together to achieve this goal. That is real healthcare reform."
The USHEI National Progress Report on Healthcare Efficiency is available for free download.
New Workers' Compensation & Automobile Medical portal now available
Emdeon Office EZBill(SM): Electronically submit Workers’ Compensation/ Auto bills and attachments at NO CHARGE
Emdeon recognizes that complex claims and attachments have a direct impact on productivity, accuracy, compliance and providers’ bottom lines. Emdeon Office EZBill overcomes providers’ challenges by providing electronic submission capability for Workers’ Compensation and Auto Medical bills and attachments.
Providers can register for Emdeon Office EZBill and submit Workers’ Compensation and Auto eBills at no charge. Emdeon Office EZBill enables the submission of eBills through direct data entry. You get complete visibility into the claim lifecycle with the Reporting & Analytics tool within Emdeon Office EZBill that allows you to track claims from point-of-submission through payment and upload the necessary attachments.
With Emdeon Office EZBill, providers will have access to Emdeon’s network of Workers’ Compensation and Auto Medical payers. For connectivity to Emdeon’s complete network of over 1,200 government and commercial payers and maximum efficiency for other transactions, providers can upgrade to the Emdeon Office Suite for a low monthly cost.
Enroll for Emdeon Office EZBill
Providers can register for Emdeon Office EZBill at https://office.emdeon.com/vendorfiles/ezbill.html or by contacting Sales at 866.369.8805. To see a complete list of Workers’ Compensation and Auto payers, visit www.emdeon.com/payerlists and select Workers’ Compensation or Automobile Medical from the payer type drop down menu.
Download complete brochure
eHealth educational seminars
A FREE seminar covering payer requirements for filing claims electronically, benefits of real-time transactions, and understanding electronic claims submission reports. Staff from provider offices, hospitals, facilities, billing services, etc. are invited to learn more about how to save money and improve efficiency by effectively utilizing electronic transactions. Participating payer representatives will be present at each seminar to answer any questions you may have about filing claims!
Please visit our EDI Transaction Center at http://www.transact.emdeon.com/ to view upcoming dates and locations in your area, register online as well as obtain other information that will help you send more transactions electronically.
Do you know?
• Top reasons claims reject
• How to resolve claim rejections
• What information is required by each payer to file claims electronically
• How to submit secondary claims electronically
• The benefits of ERA/EFT
• What electronic reports you should be receiving and how to read them
• How to maximize your potential with electronic transactions
• Various EDI transactions available today
• What EDI transactions save you the most money
• What EDI transactions payers are recommending
Come to the seminar for answers!
New payers on board
The Emdeon network of payers continues to grow
New payers added recently:
• Americas 1st Choice Health Plans of North Carolina, Inc.-Claims
• Aetna Better Health-PA Medicaid-Claims
• Aetna Encounters-Claims
• Afinity Medical Group-Claims
• American National Ins. Co. (ANICO)-ERA
• American National Property and Casualty Company (ANPAC)-Claims
• AmeriChoice of New Jersey, Inc. (Medicaid NJ)-Claims
• Auto Club Insurance Association-Claims
• Blue Cross Blue Shield of Kansas City MO-Claims
• Blue Cross Blue Shield of Kansas City MO-ERA
• Blue Cross Blue Shield of Louisiana-ERA
• Blue Cross of Nebraska-ERA
• C&O Employees Hospital Association-Claims
• CAP Management Systems-Claims
• Carolina Crescent Health Plan Inc.-ERA
• Carpenters Health and Welfare Fund of Philadelphia-Claims
• CeltiCare-ERA
• Cenpatico Massachusetts-ERA
• Cigna Encounters-Claims
• Claims Management Services-ERA
• Community Health Electronic Claims/CHEC/webTPA-ERA
• Contractors Laborers Teamsters & Engineers-Claims
• Correctional Medical Services-Claims
• CT Medicare Part A (J13 - NGS)-ERA
• Delta Dental of Arizona-ERA
• Delta Dental of Illinois-ERA
• Deseret Mutual-ERA
• DiaTri, LLC-Claims
• District of Columbia Medicaid-ERA
• Edwards Claim Administration-Claims
• First Administrators, Inc.-Claims
• Great American (GAFRI)-Claims
• Guardian Life Insurance Company of America-ERA
• Harpeth IPA/SRRIPA-Claims
• Health Partners of Minnesota-Commercial-ERA
• Health Partners of Minnesota-Medicaid-ERA
• Health Right-Claims
• Independence Medical Group-Tulare-Claims
• Integral Quality Care-Claims
• InterCare Health Plans Inc.-Claims
• J1 MAC Medicare Part A (CA,HI,NV)-ERA
• Louisiana Medicaid-ERA
• MI Medicare Part A (J8)-ERA
• Mississippi Medicaid-ERA
• MMSI-ERA
• Molina Healthcare of New Mexico-Salud-Claims
• Motion Pictures Industry-Claims
• NC Medicare Part A (J11)-ERA
• Nebraska Medicaid-ERA
• New Hampshire Medicaid-ERA
• New York State Insurance Fund (NYSIF)-Claims
• NJ Medicare Part A (J12-Highmark)-ERA
• North American Benefits Network (Cleveland, OH)-Claims
• North Dakota Medicaid (Hospital)-Claims
• NYS DOH UCP-Claims
• Physicians Care Repricing-Claims
• Premera Blue Cross-ERA
• QuikTrip-ERA
• Sanford Health Plan-ERA
• Scan Encounters-Claims
• SelectHealth-ERA
• Southeast Dental Associates-Claims
• State Farm (Casualty & Property Claims)-Claims
• Sun Life and Health Insurance Company (U.S.) (formerly GLHIC)-ERA
• Touchstone Health PSO-ERA
• Triple-S, Inc.-ERA
• UCARE of Minnesota-ERA
• United Health Plan Encounters-Claims
• Utah Medicaid-Claims
• VI Medicare Part B (J9-First Coast)-ERA
• WEA Insurance Group-Claims
• WPS Tricare TriWest-ERA
For a complete list of the payers in our network, visit our website at www.emdeon.com/payerlists/
