Emdeon Denial Manager

The Emdeon Denial Manager solution allows providers to organize and manage remittance inventory; helps staff arrange, prioritize and monitor denials and underpayments; and allows the accurate reporting and viewing of the denied and adjusted amounts. With the information produced by Emdeon Denial Manager, providers streamline the denial management process by determining root causes, patterns and process breakdowns responsible for denials, and establishing corrective steps to prevent future revenue loss or delay.

As a browser-based web application, Emdeon Denial Manager is highly compatible with most Hospital Information Systems (HIS) or Practice Management Systems (PMS), and provides users access to the Emdeon Transaction Clearinghouse, one of the nation’s largest payer connectivity networks. Files can be uploaded from the HIS/PMS, or directly from the Emdeon Transaction Clearinghouse, into Emdeon Denial Manager in the 835 or other specified format.

The analytical strengths of Emdeon Denial Manager are found in user-defined work queues designed to improve workflow. Once created, these can be assigned to users whose knowledge and expertise best fit the queue. Tasks can be easily reassigned as needed, and remittances can be designated as Open or Closed to facilitate work assignments. To ensure tasks are completed in the necessary timeframes, users can create reminders and alerts to notify them of impending deadlines. For conducting research and analysis, users are provided access to an ERA historical database warehouse where previous ERA information can be viewed and searched. 

While Emdeon Denial Manager is a highly effective, stand-alone product, it is truly powerful when coupled with the Emdeon Claim Master application. Emdeon Claim Master is Emdeon Business Services’ premier claims management solution. Once Emdeon Denial Manager identifies claims requiring adjustments and these corrections are completed, Emdeon Claim Master can quickly adjust and resubmit the revised claims. Emdeon also provides secondary claims processing as well as posting solutions.

Features

• Create work queues tailored to specific employee knowledge and expertise
• Capture and display best practice methods for resolving different types of denials
• Organize and manage remittance inventory easily
• Report accounts receivable accurately
• Access ERA historical database for trend analysis
• Audit log that tracks all actions taken on a remit
• User-defined alerts and follow-ups
• Appeal letter templates
• Utilize powerful reporting capabilities
• Integrate browser-based web application with most HIS/PMS

Benefits

• Identify causes of denials and underpayments
• Analyze vital billing department metrics quickly with configurable dashboard
• Reduce future revenue loss or delay
• Improve staff productivity, simplify cross-training
• Route work automatically to appropriate staff for remediation