Beneficiary Eligibility Management

Emdeon Beneficiary Eligibility Management services offer a unique upstream approach for efficient management and utilization of beneficiary eligibility data that achieves downstream administrative and medical cost savings. Our suite of beneficiary information-driven solutions helps government entities strengthen provider self-service, improve beneficiary care management, increase auto-adjudication rates, comply with government benefit reporting mandates and facilitate HIPAA and CORE compliance.

Eligibility, authorizations, claim status and other related inquiries are often viewed as just another communication requirement for interaction with providers. Emdeon changes that through our ability to take your beneficiary information and not only enable real-time transactions through both direct connections and hosted solutions, but also capitalize on our broad solution set to enable efficiencies in downstream healthcare costs by addressing upstream challenges, deploying more solutions with one benefit data set, faster, with minimal risk and greater return on investment.

As always, our nationwide electronic network reach allows us to connect to any system for all payer-to-provider HIPAA-mandated transactions, but the value goes far beyond facilitating traditional pre-care inquiries. By reinventing the approach to beneficiary eligibility data management, Emdeon enables you to not only serve your provider networks in the best way possible, we are helping improve beneficiary health, facilitate regulatory compliance, increase revenue and reduce costs.