Emdeon Beneficiary Responsibility Estimator^SM

As organizations look for ways to help contain costs and encourage beneficiaries to take more responsibility in managing the cost of healthcare, government entities face challenges with strained provider relations and network retention.

The Emdeon Beneficiary Responsibility Estimator^SM is an innovative tool that improves payer-provider relationships by offering providers reliable, convenient, real-time estimates of beneficiaries' out-of-pocket responsibility. Helping providers collect or establish payment at the point-of-service improves beneficiary and provider satisfaction.

The resulting enhanced provider experience helps organizations protect their provider discounts while promoting cost transparency and beneficiary healthcare accountability.

Robust eligibility and benefit data delivered through the Beneficiary Responsibility Estimator in conjunction with the estimate reduces government entities' administrative costs by offering providers more self-service functionality in determining beneficiary coverage.

Features

• Reliable estimates of beneficiary out-of-pocket responsibility, delivered via pre-care or point-of-service beneficiary benefit information, based on either:
• Integration with a payer's existing estimation solutions
• Consumer-facing, printable and customizable price quote helps beneficiaries assess treatment costs and proactively manage their healthcare
• Short implementation cycle and ongoing customer support
• Offers a solution for government entities who cannot support real-time claiming or need a complementary solution for claims that do not adjudicate in real-time

Benefits

• Reduces government administrative costs associated with provider telephone inquiries and pre-determination claims
• Improves providers' satisfaction levels by increasing beneficiary collections and reducing bad debt
• Improves beneficiaries' satisfaction levels by providing price transparency and setting expectations on cost of care
• Helps ensure network retention