Popular Solutions
Payment Integrity Services
Protection from Fraud, Abuse and Waste
Emdeon Payment Integrity Services help you identify, process and accurately pay only valid healthcare claims efficiently while reducing healthcare dollars lost to fraud, abuse and waste. This suite offers comprehensive solutions that easily integrate with your existing claims workflow. These solutions can be tailored to meet your immediate needs but also adapt as your organization changes and grows. With its unparalleled repository of claims data, Emdeon has the ability to streamline the information exchange and interpretation enabling detection of aberrant claims that currently may go unseen resulting in significant savings for your business.
Emdeon's innovative solution set offers the most complete healthcare fraud, abuse and waste solution available today. Our product suite empowers payers of all sizes to intelligently automate processes that previously required a significant investment in human resources and IT infrastructure. When no longer forced to only manage suspect or irregular claims using a retrospective pay-and-chase model, organizations are more productive and efficient. Emdeon can help you be confident that when you pay a claim, it's a payment worth making.
Want to reduce your exposure to fraud? Let the healthcare efficiency experts review your business and apply our knowledge to your bottom line.
Contact UsFeatured Products
Emdeon Fraud Prevention helps remove unnecessary costs from healthcare by identifying claim aberrance and catching potentially fraudulent, abusive or wasteful claims early in the claim lifecycle—even pre-adjudication.
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Emdeon's highly flexible modular offering facilitates an integrated approach to fighting fraud and abuse within a comprehensive Payment Integrity solution.
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Emdeon Clinical Integrity for Claims offers payers flexible and transparent claims edits that leverage more than 16 million rules based on protocols from the American Medical Association, Centers for Medicare and Medicaid Services and other industry sources.
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Leveraging the industry's most comprehensive payer network and a history of partnering with commercial and government payers, Emdeon Third-Party Liability Analysis manages the process of identifying, validating and verifying coordination of benefit opportunities.
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Payer News: Emdeon Connection
The Emdeon Connection eNewsletter provides information to our government and commercial payer audience.
Congress Begins Task of Merging Five Health Reform Bills into One
As healthcare annual spending tops $2.4 trillion, the stakes are high as Congress faces conflicting pressures to expand coverage and curtail spiraling costs.
Member Eligibility Management...Moving Efficiencies Upstream in the Healthcare Cycle
In a market where efficiencies equate to increases in the bottom line, payers continuously look for additional solutions where they can do more with minimal resources.
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