Claims Administrators & Operations Executives

Emdeon is unique in that it offers pre- and post- adjudication services spanning the entire payment life cycle from inbound electronic and paper claims processing to outbound remittance and payment. By combining electronic and paper processing capabilities, Emdeon is uniquely able to focus on reducing paper submissions, reducing outgoing EOB and check mailing expense and increasing auto-adjudication rates. Payers using Emdeon’s services also benefit from Emdeon’s substantial investment in creating the infrastructure for financial and clinical communication in healthcare. These benefits include:

Access to the largest network of submitting providers and vendors in the nation
Ability to apply advanced payer-specific edits and claims cleaning solutions prior to receiving claims
Support for the full range of transactions including eligibility inquiries, pre-certifications, authorizations, claims status, electronic remittance advice and EFT
Access to Emdeon's EDI Growth programs, which convert providers from paper to electronic submission and remittance
Cost advantages afforded by leveraging Emdeon's ongoing investments in technology, products and services

Imaging and Data Capture
Emdeon offers the most
direct, cost-effective front-end processing, and is the only provider of both industry-leading OCR software automation and business process outsourcing (BPO) solutions for automated mailroom, scanning, claim
data capture, data validation, claims editing, automated workflow and secure on-line document management.

Emdeon DocIT
Emdeon HealthClaim Expert
Emdeon Transform Suite
Emdeon WebSearch
Emdeon BPO Solutions

Payment Distribution and Communication
For healthcare payers and third-party administrators, Emdeon is a premier solutions provider of electronic funds transfers (EFTs), payment distribution and network communications, including electronic remittance advices (ERAs) to physicians and explanation of benefits (EOB) to patients. From start to finish, you can also outsource your forms processing and fulfillment with our
streamlined BPO services.

Emdeon Client Access System
Emdeon System Integration
Emdeon Document Design System
Emdeon Printing and Fulfillment
Emdeon Healthpayers USA
Emdeon API Integration

Electronic Data Interchange

Emdeon leads the industry in clearinghouse and e-commerce solutions for unified EDI workflow. We offer the best and most reliable connectivity services and network reach — addressing payer-to-provider HIPAA-mandated transactions in a secure environment.

Emdeon Direct Connect
Emdeon Empower
Emdeon Clearinghouse Network
Emdeon Managed EDI Gateway
Emdeon Medicare Crossover Solution

Advanced Claiming
Emdeon Advanced Claiming takes the complexity out of EDI by connecting healthcare organizations to more of their trading partners and delivering electronic information in a customer-specific format.

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