Emdeon

Prescription Benefit Administration

Emdeon provides the systems infrastructure as well the administrative support necessary to allow payers to effectively manage their prescription benefit program in-house. Emdeon's award-winning and flexible claims processing system supports complex benefit designs, multiple networks and client-owned contracts.

Want to automate payment posting? Let the healthcare efficiency experts review your business and apply our knowledge to your bottom line.

Contact Us

Just tell us what you need. Emdeon can tailor our services to provide as much assistance as your organization needs:

  • Our core service is pharmacy claims adjudication and data reporting
  • We can provide transparent call center support for member and pharmacy calls
  • We encourage and assist our clients in negotiating their own Retail Pharmacy Networks and maintain a MAC list while we handle the network administration
  • We encourage our clients to hold their own Drug Manufacturer Rebate Contracts while providing them with additional clinical support and a drug manufacturer contract management tool to reconcile rebates with the manufacturers.

    Pharmacy Claims Adjudication: The state-of-the-art SelectRx system offers a cost-effective alternative for the task of operating and maintaining an in-house pharmacy claims adjudication system. It includes Emdeon SelectRx Insight ad-hoc reporting.

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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  • The U.S. Healthcare Efficiency Index is a forum for raising awareness and monitoring business efficiency in healthcare.

  • We are working diligently to deliver solutions enabling our customers to meet HIPAA 5010 requirements seamlessly!