Bulletin. Please note, registration with Emdeon is not required to receive payment.

Transcription

1 Bulletin Simply Healthcare Plans 9/1/2013 SIMPLY PARTNERS WITH EMDEON ON NEW ELECTRONIC FUNDS TRANSFER AND VIRTUAL CREDIT CARD PROCESS! Simply Healthcare is committed to strengthening its relationship with its outstanding provider partners. We are listening to you and making improvements that will assist you in providing excellent care to our members. Simply will offer Electronic Funds Transfer (EFT) and Virtual Credit Card (VCC) services, via Emdeon September 1, If you are a participating provider with Emdeon, you will begin receiving Simply payments via your registered preferred method. Contact Us (877) Eligibility Verification, Prompt # 1 Referrals and Authorizations, Prompt # 2 Claims Status, Prompt # 3 Provider Relations, Prompt # 4 Pharmacy Department, Prompt # 5 If you are not registered with Emdeon and have a Point of Sale Device, you will receive payments via the VCC process. If you not registered with Emdeon and do not have a Point of Sale Device, you will receive a paper check or you can register with Emdeon to create an account Please note, registration with Emdeon is not required to receive payment. The EFT and VCC process optimizes cash-flows by having faster access to funds. We are very excited to introduce our latest enhancement. : FAQ Q-What if I am an existing EMDEON customer? A-No action required, Emdeon will send the existing provider Simply s payment the same way other payments are currently received. Q-What if I am not registered with Emdeon and want to be enrolled? A-You can view the Emdeon How to enroll online pamphlet on or call Q-If I am an existing customer with Emdeon, can I opt out of the EFT or VCC Process? A-Yes, when you log on to Emdeon you will be prompted a question on whether you would to opt-out of EFT or VCC and receive paper checks. Q- Will I have to enroll with each payer to receive a Virtual Card Payment? A- No, this transformative solution removes the need to enroll with each payer. Virtual Card Payments can be processed through the Point-of-Sale (POS) device you already have in your practice. Mailing Address: 1701 Ponce de Leon Blvd. Coral Gables, FL

2 Simplifying the Business of Healthcare Emdeon epayment Enrollment and Authorization Form Instructions Providers can switch from paper to electronic payments by enrolling in Emdeon epayment in three easy steps! If you have questions about this Emdeon epayment Enrollment and Authorization Form, can t locate your username or password for the Emdeon EFT Online Enrollment Tool or if you need help accessing Emdeon Payment Manager, please call and select option 1. Step 1 - Pick an Enrollment Method and Initiate Enrollment You have several options for enrollment. You can enroll online, or simply complete the Emdeon epayment Enrollment and Authorization Form and return it to Emdeon by , mail or fax to complete your enrollment. Please note, you only need to return pages 2-8 of the Emdeon epayment Enrollment and Authorization Form. Below includes detailed instructions for each enrollment method. How to Enroll Online (Recommended) Complete the Emdeon epayment Enrollment and Authorization Form at After your information is verified, you will receive an with your account information and instructions for completing your enrollment including setting your Payer preferences and adding bank accounts. How to Enroll Online and Submit the Emdeon epayment Enrollment and Authorization Form by This Emdeon epayment Enrollment and Authorization Form includes form fields enabling you to (optionally) complete it using your computer online and insert a digital signature. your completed Emdeon epayment Enrollment and Authorization Form as an attachment to EFTEnrollment@Emdeon.com. How to Enroll by Fax Fax your completed Emdeon epayment Enrollment and Authorization Form to How to Enroll by Mail Mail your completed Emdeon epayment Enrollment and Authorization Form to: Emdeon Electronic Payment Service Enrollment Request P.O. Box Nashville, TN Step 2 - Confirm Deposit to Verify Account Once you have completed enrollment, Emdeon will make a small deposit in your designated bank account with the reference note EFT Enroll. After this has been deposited into your designated account, please call for verification purposes. Upon confirmation of the deposit amount, if you are an existing Payment Manager user, your services will be enabled under the assigned account. If you are a new Payment Manager user, you will be given a username and password for your new account. Step 3 - Start using Emdeon Payment Manager to Search, View, Download and Print ERAs You may access Emdeon Payment Manager to search, view and print your payment and remittance advice for participating Payers. To see a quick tour of Emdeon Payment Manager, visit Page 1 of 8 Questions? Call (Option 1) for assistance.

3 Attachment 1: Provider Information If you require additional space to add Providers, please reprint or copy this Emdeon epayment Enrollment and Authorization Form. On subsequent pages, please ensure that the Billing Provider numbering is changed. Please note: The information you provide on Attachments 1-5 will be used to facilitate EFT payments to you for all Payers you elect to participate with. Check here if you are updating existing enrollment information. Provider #1 (Please Print or Type) Provider Name Provider Federal Tax Identification Number (TIN) or Employer Identification Number (EIN) Street City State/Province ZIP Code/Postal Code Telephone Number Fax Number Address Provider #2 (Please Print or Type) Provider Name Provider Federal Tax Identification Number (TIN) or Employer Identification Number (EIN) Street City State/Province ZIP Code/Postal Code Telephone Number Fax Number Address Provider #3 (Please Print or Type) Provider Name Provider Federal Tax Identification Number (TIN) or Employer Identification Number (EIN) Street City State/Province ZIP Code/Postal Code Telephone Number Fax Number Address Page 2 of 8 Questions? Call (Option 1) for assistance.

4 Attachment 2: Provider Contact Information Emdeon will only release information to the authorized individuals listed in this section. Provider Contact Name (Representative #1) Name Title Telephone Number Address Provider Contact Name (Representative #2) Name Title Telephone Number Address Provider Contact Name (Representative #3) Name Title Telephone Number Address Provider Contact Name (Representative #4) Name Title Telephone Number Address Page 3 of 8 Questions? Call (Option 1) for assistance.

5 Attachment 3: Financial Institution Information If you need to add more than three bank accounts, please reprint this page. On subsequent pages, please ensure that the Bank Account numbering is changed. For Aetna EFT enrollment only: If you have more than one bank account to enroll, please fill out a separate enrollment form for each account and include a bank letter or voided check for each account. Financial Institution Account #1 Financial Institution Name Street City State/Province ZIP Code/Postal Code Financial Institution Account Owner Name Type of Account at Financial Institution Financial Institution Routing Number Provider s Account Number with Financial Institution Financial Institution Account #2 Financial Institution Name Street City State/Province ZIP Code/Postal Code Financial Institution Account Owner Name Type of Account at Financial Institution Financial Institution Routing Number Provider s Account Number with Financial Institution Financial Institution Account #3 Financial Institution Name Street City State/Province ZIP Code/Postal Code Financial Institution Account Owner Name Type of Account at Financial Institution Financial Institution Routing Number Provider s Account Number with Financial Institution Page 4 of 8 Questions? Call (Option 1) for assistance.

6 Attachment 4: Payment Routing Information Emdeon will distribute your funds in accordance to the information provided in this Attachment. Instructions for completing Table 1 within Attachment 4: 1. Review the list of participating payers listed in Tables 2, 3 and 4 within Attachment Specify which payers you wish to receive claims payments via EFT by listing the Payer ID and Payer Name within Table 1 below. 3. Specify the appropriate Billing Provider # for each selected payer as listed in Attachment Within Table 1, list the Supplemental Provider ID if required. Payers listed within Table 3 require this additional information. 5. Specify the appropriate Bank Account # for each selected payer as listed in Attachment 3. Table 1: Payment Distribution Instructions by Banking Account and Payer Payer ID Payer Name Billing Provider # (Attachment 1) Supplemental Provider ID Bank Account # (Attachment 3) (e.g.) ABC Health Plan #1 N/A #1 Page 5 of 8 Questions? Call (Option 1) for assistance.

7 Attachment 4: List of Enrolled Payers To simplify enrollment, list ALLTIN in the Payer ID section of Table 1 within Attachment 4 to indicate your enrollment with all currently enrolled Payers that do not require additional information. Table 2: Direct Payment Payers The payers listed below are offering to distribute EFT payments directly to you and not through Emdeon. If you select a payer below, that payer will pay you directly and Emdeon shall not be involved in any of their payment transactions. As such, Emdeon makes no representations or warranties regarding the payment services provided by the payers set forth below. Additional Provider ID Payer ID Payer Name Required/Optional (R/O) Additional Requirements LOB Aetna NPI - (R) Provide a voided check or banking letter (Photocopies are acceptable). Ensure M the routing and account information on the check matches the bank account you designate to receive EFT payments from Aetna. If you are providing a banking letter instead of a voided check, please ensure it is printed on your bank s letterhead and includes your routing number, account number, the account holder s name and is signed by an authorized bank representative Amerigroup Legacy PIN (R) Providers must enroll using Amerigroup assigned Provider Identification Number. ERA is only M, H available with EFT enrollment. SB580 CareFirst NPI (R) Providers must enroll or be enrolled for Electronic Remittance Advice (ERA) when selecting M, H CareFirst EFT. Are you currently setup for ERAs with CareFirst? and Provider q Yes q No If you are not yet enrolled and want to enroll for both ERA and EFT from CareFirst please check the Group Number following box. q (You will receive CareFirst ERAs through Emdeon if this box is checked.) Coventry Health Care Tax ID - (R), NPI - (O) Does the bank account you listed in Attachment 3 apply to all facilities/providers under this Tax ID? M, H Yes No If no, please specify names and NPIs that should be set up for EFT Humana Inc. N/A Providers must enroll or be enrolled for Electronic Remittance Advice (ERA) when selecting M, H Humana EFT. Are you currently setup for ERAs with Humana? q Yes q No If you are not yet enrolled and want to enroll for both ERA and EFT from Humana please check the following box. q (You will receive Humana ERAs through Emdeon if this box is checked.) MHNet Tax ID - (R), NPI - (O) Does the bank account you listed in Attachment 3 apply to all facilities/providers under this Tax ID? M, H Yes No If no, please specify names and NPIs that should be set up for EFT. Table 3: Payers That Do Not Require Additional Information Payer ID Payer Name ALLTIN All currently listed Payers that only require TIN N/A Administrative Concepts, Inc D, M American Family Insurance Group M American Republic World Insurance Group M Bluegrass Family Health M Central Reserve Life Insurance Company M Community First Health Plans M Continental General/Provident American Life and Health M, H Continental Provident M CUP M CX035 Dental Care Plus D CX093 Dental Select D Everence D, M FirstCare Health M, H, D Foundation for Medical Care of Tulare and Kings Countries M Guardian Life Insurance Company D, M HCH Administration (IL) M Health Alliance Medical Plans M John Alden Life Insurance Company M SX159 Lovelace LHP - Brokers Only Brokers Lovelace LINC - Brokers Only Brokers Mennonite Mutual Aid M, H R0755 Ohio Benefit Administrators M SX158 Paramount Health M Preferred Care Partners M Sanford M SX142 South Indiana Health Operations - HMO M Teacher s Health Trust M Texas Children s Health Plan - CHIP M Texas Children s Health Plan - STAR M Time Insurance Company M Tower Life Insurance Company D, M Union Security Insurance Company M Wells Fargo TPA D,M World Corp M Page 6 of 8 Questions? Call (Option 1) for assistance. LOB

8 Table 4: Payers That Do Require Additional Information To simplify enrollment, list ALLNPI in the Payer ID section of Table 1 within Attachment 4 to indicate your enrollment with all currently enrolled Payers that do not require additional information. Additional Provider ID Payer Name Required/Optional (R/O) LOB ALLNPI All currently listed Payers that require TIN + NPI NPI (R) N/A CX097 Access Dental NPI (R) D Advocate Health Partners Legacy ID (R) M Affinity Legacy ID (O) M AmeriBen NPI (R) M AmeriHealth Mercy Health Plan Legacy ID (R) M, H AmeriHealth Northeast LLC Legacy ID (R) M, H Arbor Health Plan Legacy ID (R) M, H Blue Cross Blue Shield of Vermont NPI (R) M, H Bravo Health NPI (R) M CareFirst Administrators/NCAS NPI (R) M, H CBHNP- Amerihealth Legacy ID (O) M, H Celtic Insurance NPI (R) M, H Central Reserve Life Insurance Company NPI (R) M, H Continental General Insurance Company NPI (R) M, H Employee Plans, LLC Legacy (R) M, H, D Florida True Health, Inc NPI (R) M, H CIGNA - Central Reserve Life Insurance Company NPI (R) M, H CIGNA - Continental General Insurance Company NPI (R) M, H CIGNA - Great American Life Insurance Company NPI (R) M, H CIGNA - Loyal American Life Insurance Company NPI (R) M, H CIGNA - Provident American Life & Health Insurance Company NPI (R) M, H CIGNA - United Teacher Associates Insurance Company NPI (R) M, H Genworth Wakely LOB NPI (R) M, H Great American Life Insurance Company NPI (R) M, H Hawaii Medical Assurance Association (HMAA/HWMG) Legacy ID (O) D, M Health First Health Plans NPI (O) M, H Health Plus Legacy ID (R) M Healthcare Partners IPA Vendor ID (R) M Horizon NJ Health Legacy ID (R) M, H SX073 Independent Health Providers Tax ID (R) M Pharmacy Payee ID (R) Keystone Mercy Health Plan Legacy ID (R) M, H LA Care Legacy ID (R) M, H Loyal American Life Insurance Company NPI (R) M, H MDWise Hoosier Alliance Legacy ID (R) M, H EM039 Med3000 PEDICARE TITLE 19 Provider ID (R) M, H, D EM205 Med3000 CMS TITLE 21 Provider ID (R) M, H, D EM284 Med3000 CMS SAFETY NET Provider ID (R) M, H, D EM350 Med3000 CMS EARLY STEPS Provider ID (R) M, H, D EM522 Med3000 PEDICARE TITLE 21 Provider ID (R) M, H, D EM843 Med3000 CMS TITLE 19 REFORM Provider ID (R) M, H, D MedBen NPI (O) M, H, D Network Health Provider ID (R) M Passport Health Plan Legacy ID (R) M, H TH131 Physicians United Plan Legacy ID (O) M CX078 Premier Dental Providers NPI (R) D Brokers Agency ID (R) Provident American Life & Health Insurance Company NPI (R) M, H SCAN Health Plan Vendor ID (R) M, H, D LIFE1 Secure Horizons Lifeprint Arizona NPI (O) M Select Health of South Carolina Legacy ID (R) M, H Sierra Health Services NPI (R) M Sterling Life NPI (R) D, M TML Intergovernmental Employee Benefits NPI (R) D, M United Healthcare Student Resources NPI (R) Tax ID (R) M, H United Teachers Associates Insurance Company NPI (R) M, H Upper Peninsula Health Plan NPI (R) M Windsor Medicare Extra Vendor ID (R) M, H Zepherella NPI (O) M Viva Health Vendor ID (R) M, H Payer ID Legend Legacy ID (R) indicates the Legacy ID (payer assigned provider ID) is required by the payer Legacy ID (O) indicates the Legacy ID (payer assigned provider ID) is not required by the payer NPI (R) indicates the National Provider ID is required by the payer NPI (O) indicates the National Provider ID is not required by the payer Brokers Agency ID (R) indicates the agency ID is required for brokers LOB: Line of business for which the payer is enabled for EFT with Emdeon D Dental M Medical P Pharmacy H Hospital Page 7 of 8 Questions? Call (Option 1) for assistance.

9 Attachment 5: Emdeon epayment Enrollment and Authorization Form Acknowledgement By signing below, Provider acknowledges that it is read, agrees that it is subject to and agrees to comply with the Emdeon General Terms and Conditions, the Business Associate Terms, the epayment Services Addendum and the Privacy Policy for Emdeon.com. To view the Emdeon General Terms and Conditions, the Business Associate Terms and the epayment Services Addendum please visit: To view the Privacy Policy for Emdeon.com, please visit In addition, by signing below, Provider represents and warrants that all of the information that it is providing to Emdeon is accurate and complete. In furtherance of the epayment Services, Provider authorizes Envoy LLC or one of its Affiliates to initiate ACH debit and credit entries to the above account(s) at the above depository financial institution(s). Provider acknowledges that the origination of ACH transactions to the above account(s) must comply with the provisions of U.S. law. Provider also acknowledges that in the provision of the epayment Services, the Provider s enrollment information will be made available to the Payers making payment to the Provider through the epayment Services. If Provider desires to revoke or modify the authority of any Authorized Representative or add additional Authorized Representatives, Provider must execute and deliver to Emdeon a new Attachment 2. Letters or other forms of communications will not be accepted. Any subsequent Attachment 2 supersedes any previously submitted Attachment 2. CURRENT AUTHORIZED REPRESENTATIVES NOT ON THE NEW ATTACHMENT WILL NOT BE RECOGNIZED. Please check the box below if you have elected to receive payments from Direct Payment Payers. I hereby authorize Direct Payment Payer(s) to initiate ACH credit and debit entries to the account(s) listed in Attachment 3 for all benefits payments. Provider acknowledges that the origination of ACH transactions to the above accounts must comply with the provisions of U.S. law. This agreement will remain in effect until I notify the Direct Payment Payer(s) of the desire to cancel or change this service or until I am notified by Direct Payment Payer(s) that this service has been terminated. I understand I must allow reasonable time for my instructions to be executed. As required by 42 C.F.R and , I understand in accepting electronic payment that such payment may be from Federal and State Funds and any falsification or concealment of a material fact may be prosecuted under Federal law. IN WITNESS WHEREOF, the parties have caused this Emdeon epayment Enrollment and Authorization Form to be executed by their respective duly authorized representatives. Provider Contact Information Name Title Telephone Number Address Authorized Signature Date rev 4.13 Page 8 of 8 Questions? Call (Option 1) for assistance.

10 EMDEON VIRTUAL CARD PAYMENTS Simplifying the Business of Healthcare

11 How Much Could You Be Eligible to Receive? By switching provider payments from paper checks to Virtual Card Payments, you could be eligible to receive revenue share payments from Emdeon. Virtual Card Payments at a Glance Using Virtual Card Payments, providers can accept your claims payments electronically using existing payment card networks instead of receiving paper checks. Similar to how providers process co-payments today when patients present a credit card for payment, providers enter card account information into their POS terminals and the funds are deposited virtually immediately into their existing merchant account. Virtual Card Payments are processed similarly to credit card payments in the provider s office, but a physical, plastic card is never issued. The card information is simply printed and mailed to the provider with the Explanation of Payment (EOP). Emdeon Payment Network Virtual Card Payments are just one component of the Emdeon Payment Network, a comprehensive suite of services that combines electronic and print payment infrastructures. By combining our vast network of providers and payers with established relationships with financial institutions, payment card processers and Emdeon owned and operated print centers, Emdeon Payment Network can help give you an edge across all payment distribution methods. Why Multiple Channels? If your long-term goal is to move the majority of your provider payments from print to electronic, you need the flexibility to leverage a variety of provider payment channels during your transition. For example, you may prefer to migrate the majority of your low value claim reimbursements (below a $5,000 threshold) to Virtual Card Payments. Additionally, in instances when providers may opt-out of high value claim reimbursements, you can leverage other low cost payment mechanisms such as Automated Clearing House (ACH) direct deposit and Image Cash Letter (ICL) payments as electronic payment alternatives. And, for any remaining payments, Emdeon can economically print and mail those documents too using our printing and fulfillment services including our unique postage cooperative. One Vendor + One Payment File = Easier Implementation and Reconciliation Instead of using separate vendors to handle your print and electronic provider payments, Emdeon can take your single payment file and convert it into a variety of payment methods to help you efficiently pay your providers. Why is that so important? Having a single partner to handle your provider payments helps you save valuable time and makes it much easier to reconcile payments across multiple payment methods. Emdeon Payment Network Infrastructure Emdeon epayment Mailed Check Payments Virtual Card Payments ACH Payments ICL Payments Emdeon Healthpayers USA Postage Cooperative Emdeon Printing and Fulfillment *Copyright MasterCard Worldwide All rights reserved. MasterCard is in no way affiliated or associated with Emdeon. At Emdeon, we re here to help. To transform the way you run your healthcare business today, call us at 877.EMDEON.6 ( ) for a complimentary review. 03

12 Overview Payers like you have been taking notice of Virtual Card Payments recently. Why? Because there are substantial cost savings opportunities when traditional paper check payments are replaced with Virtual Card Payments. Using Virtual Card Payments, not only can you save money, but Emdeon could even pay you based on your Virtual Card Payment transaction volume.** Prior to the arrival of Virtual Card Payments, many payers attempted to route more payments electronically via ACH direct deposit in an effort to reduce the administrative expenses associated with printing and mailing paper checks. Since provider enrollment is required to switch from paper to ACH payment distribution, payers can be limited in successfully delivering the majority of their payments electronically which, unfortunately, can also limit their ability to save money. Some payers were identified as having the potential to receive several million dollars each year. * Your savings * could potentially exceed what you are paying today to print and mail checks. And, we re not talking about just a few dollars in savings here and there. Your savings could potentially exceed what you are paying today to print and mail checks. Based on an analysis of numerous payers paper check-based payment distribution volume (facilitated by Emdeon), some payers were identified as having the potential to receive several million dollars each year based on converting their organization s annual paper check-based provider payments to Virtual Card Payments. Easily Processed by Providers Virtual Card Payments do not require the swiping of a physical card for payment to occur. To send a payment, Emdeon prints the 16-digit card number, payment amount, Card Verification Code (CVC) and expiration date with the provider s EOP. To process the payment, the provider inputs the card information into their POS terminal. It is important to note that the merchant processing fee that providers incur when processing Virtual Card Payments is not dictated by you or Emdeon. This is the same rate that the provider previously negotiated individually with their preferred merchant processor. Unleash Your Ability to Reduce Print Distribution Expenses With Virtual Card Payments, you are no longer held back by the barrier of provider enrollment. This is an important facet of Virtual Card Payments since you can be empowered to switch the majority, or even all, of your provider payments from paper checks to Virtual Card Payments and reap a substantial cost savings as a result. Virtual Card Payments offer mutual benefits. For providers, payment is received quickly and simply without the hassle of program enrollment or paper check deposit procedures. Plus, the transfer of funds is virtually immediate, similar to credit card transactions. For you, there s a significant cost reduction. In some instances, you may receive sizeable payments depending on your Virtual card transaction volume. *Based on an analysis of Emdeon proprietary data. **Estimated potential annual value will be based on converting your organization s annual paper-based provider payments distributed by Emdeon to Virtual card payments as well as certain assumptions on payment conversion rates, provider adoption rates, applicable merchant processing fees and EPN services selected, among other items. *Estimated potential annual value will be based on converting your organization s annual paper-based provider payments distributed by Emdeon to Virtual card payments as well as certain assumptions on payment conversion rates, provider adoption rates, applicable merchant processing fees and EPN services selected, among other items. Your Organization * Contact Us Today! 877.EMDEON.6 ( ) At Emdeon, we re here to help. To transform the way you run your healthcare business today, call us at 877.EMDEON.6 ( ) for a complimentary review. 05

13 Provider Acceptance of Virtual Card Payments Virtual Card Payments represent an optional payment solution for providers. Providers may instead choose to receive reimbursements by ACH direct deposit (from participating payers) or paper check. Providers need to call the Emdeon Payment Network support team to verify or update their payment preferences. Providers electing to switch to ACH direct deposit have several convenient options for Emdeon epayment enrollment which are described online at Provider Acceptance of Multiple Payment Methods There may be occasions in which providers receive payments through combinations of payment types as more payers transition to Virtual Card Payments. However, they will never receive reimbursement through a method they have not stated among their payment preferences. For example, Payer A may distribute claims payments to Provider X via Virtual Card Payments while Payer B may still be distributing claims payments via paper checks to Provider X. In this scenario, Provider X is receiving two types of claims payments from two different payers, though never receiving duplicate payments for the same reimbursement. Provider Participation: Opt-Out Model Emdeon has created a turnkey solution. If payers agree to an opt-out strategy recommended by Emdeon, payers are not required to enroll providers into the program. Unless or until a provider alerts Emdeon that they would like to receive an alternate form of payment, providers are automatically set up to receive Virtual Card Payments from participating payers. Virtual Card Payment Security Measures The card information is generated securely and seamlessly integrated into Emdeon s system. Card numbers are activated and assigned expiration dates only when payments are ready to be sent. Card information is sent with EOP s directly to existing designated contacts within the provider organizations. Each payment is assigned its own card number; the monetary value of the Virtual card is equal to the payment amount for which it was issued. Virtual card numbers are credit card numbers, 16-digits in length and assigned specific dollar values, as well as corresponding expiration dates and CVC. Optional General Ledger (GL) clearing account numbers or reference numbers can also be provided. To process transactions, providers must correctly input the card number and expiration date (at minimum). Some POS terminals also require a CVC if a physical card has not been swiped. A card number is valid only up to the total amount for which it is issued. Once that dollar value has been reached, the card number is no longer functional. Thus, providers do not need to keep these numbers on file. Security restrictions can be added to only allow Virtual Card Payments to be processed using a POS terminal associated with specific merchant codes (e.g. Healthcare related merchant accounts). Virtual Card Payment Expiration Date After the expiration date, a Virtual Card Payment is no longer valid. Emdeon will not reissue the number or assign a new expiration date. Just as with paper check depositing, providers bear the responsibility for processing their Virtual Card Payments in a timely fashion. Reporting Availability Emdeon generates two daily reports for Virtual Card Payments. Payment Register Report Used by payers to identify the payment method utilized for each provider payment distributed. This is helpful when payers are using a variety of payment distribution methods. This report is generated following each production release which normally occurs at approximately 10:00 am Central Time each business day. The production release is triggered when Virtual Card Payment information has been generated. This report lists the payer s payments from that day s release and denotes the payer s original check number for each payment to be made and the final method by which the payment will be processed: check, ACH or Virtual Card Payment. Payers have the option to receive Payment Register Reports with or without claim numbers associated with payments. They may access these reports through a secure File Transfer Protocol (FTP) site or receive them by . Funding File Report Used to notify payers that Emdeon will be withdrawing funds to cover the Virtual Card Payments processed by providers the previous day. This report is relevant for payers who opt for the post-funded model, meaning they choose to fund the Virtual Card Payments after the Virtual Card Payments are authorized (see details in the next section of this document). This report is run each business day at approximately 10:00 am Central Time and reflects debit and credit transactions that occurred the previous day. With this report, payers are notified regarding the total funds that Emdeon will withdraw from their bank account in order fund the Virtual Card Payments, as well as details for each payment represented therein. Payers may access these reports through a secure FTP site or receive by . At Emdeon, we re here to help. To transform the way you run your healthcare business today, call us at 877.EMDEON.6 ( ) for a complimentary review. 07

14 Advantages of Virtual Card Payments for Providers Simplifies electronic payment acceptance for providers since neither registration nor enrollment with the payer is required Eliminates the cost and hassle of processing paper check-based claims payments Eliminates the risk of checks being lost or stolen Follows a transaction process most providers are already familiar with requiring minimal instruction to get started Provides an economical method of processing payments since the merchant fees incurred by providers are, on average, of relatively low dollar value and in the range of fees already incurred by providers accepting credit card payments from patients* Accelerates cash flow since transactions are processed virtually immediately Advantages of Virtual Card Payments for Payers Emdeon Virtual Card Payments represent an important step in the right direction to help you cut provider payment distribution costs Emdeon could even end up paying you for provider payments sent via Virtual Card Payments Eliminates the hassle of printing and mailing of checks Processes payments electronically to increase efficiencies and profitability Eliminates the hassle of managing provider enrollment for ACH Virtual Card Payment Routing Overview 1. Provider submits claim to payer. 2. Payer processes the claim. 3. Payer submits provider payment file to Emdeon. (This file may contain data only for providers receiving Virtual Card Payments or it may also include data for all provider payment types.) 4. On behalf of the payer, Emdeon prints and mails the EOP to the provider with the 16-digit card number, payment amount, expiration date and CVC. 5. Provider manually inputs the card number, payment amount, expiration date and CVC into their POS terminal. Once the transaction has been processed for the total amount allotted to the card, the card information is no longer valid. 6. A secure payment transaction occurs virtually immediately. 7. If the post-funded model is selected, the funds are withdrawn from the payer s financial institution account. 8. The payer receives a reconciliation report from Emdeon. 9. Based on transaction volume, the payer may receive a payment from Emdeon.* *Estimated potential annual value will be based on converting your organization s annual paper-based provider payments distributed by Emdeon to Virtual card payments as well as certain assumptions on payment conversion rates, provider adoption rates, applicable merchant processing fees and EPN services selected, among other items. Emdeon is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers and patients in the U.S. healthcare system. To learn more, visit our website at Emdeon Business Services LLC. All rights reserved. EMDA rev Lebanon Pike, Suite 1000 Nashville, TN USA 877.EMDEON.6 ( )

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16 EMDEON epayment SOLUTIONS Simplifying the Business of Healthcare

17 Comprehensive payment solutions Simplify electronic payments Market demands on payers continue to make efficiency and profitability the key difference between success and struggle. To get ahead, today s payers need to find the best ways to lower cost and increase profitability within the daily business of healthcare, and the fractured payment process is primed for evolution. Emdeon epayment is the comprehensive, flexible solution to simplify electronic payment transactions with one partner while enabling payers to reduce distribution and support costs. Valuable knowledge and experience Emdeon is positioned to lead the way in transitioning healthcare payments from paper-based to electronic services, much like we have for claim submissions. With routine distribution of hundreds of millions of paper and electronic payments to nearly 500,000 providers each year, and efficient print volume of more than 700 payers, we have the experience and the connectivity to effectively promote provider adoption. Our comprehensive solutions and services give you low cost electronic payment capabilities that work in-line with world-class print and mail processes, while simultaneously encouraging provider enrollment. When it comes to your time, money and energy expended, less is more. Raise the scale in your favor. Electronic Payments Costs Less No postage and materials Lower bank transaction fees No stop payment / re-issue fees More Efficient No lost payments Fewer retrievals of overpayments Decreased days claim outstanding Improved Provider Relations Simplified workflow Self-service tools to track payments Enhanced cash flow and automated reconciliation Paper Payments Costs More Postage and materials Bank check processing fees Stop payment / re-issue fees Less Efficient Customer calls for lost payments More retrievals of overpayments Longer days claim outstanding Strained Provider Relations Manual tracking and posting of payments or lockbox P2E Calls to track down lost payments Longer payment and reconciliation cycles Emdeon epayment for Payers Smarter workflow delivers better results Emdeon epayment delivers a single-partner solution that simplifies payment and remittance distribution. epayment is the most efficient way to pay providers today, and the answer to lowering costs while providing even better service. Emdeon also uses effective provider outreach programs that encourage providers to shut-off the paper processes so you can realize the maximum benefits our cost-friendly electronic services deliver. Save with every payment By utilizing electronic processes delivered through Emdeon epayment, payers can reduce daily operating costs to increase profitability. Compared to paper payments, electronic payments generally have much lower bank fees per transaction, and the cost to retrieve overpayments is often far less. Accordingly, as electronic adoption increases over time these savings can become even more significant and can help improve margins. Contact Us Today! 877.EMDEON.6 ( ) At Emdeon, we re here to help. To transform the way you run your healthcare business today, call us at 877.EMDEON.6 ( ) for a complimentary review. 03

18 epayment Delivery Methods for Payers Flexible payment formats Emdeon epayment delivers the flexibility and comprehensive approach needed to meet your complex payment needs. During implementation we can create a variety of ways to convert your payments into automated and efficient Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs). Emdeon epayment EFT Suite ACH Direct (Payer Bank) features NACHA files created on your behalf and submitted to your preferred bank(s) to execute ACH transactions. This can greatly benefit payers that require full control of funds throughout the entire ACH distribution process. When paired with our 835 ERA service delivery, electronic payments can be linked and delivered in tandem to ease provider reconciliation. ACH Disbursement (Emdeon Bank) consolidates multiple payments into a single transaction, then debits them from payer accounts via ACH to a centralized clearing account for aggregation and distribution to providers. By reducing the number of ACH debit transactions, this model can offer you substantial bank savings in addition to the administrative cost benefits of paperless payments. When paired with our 835 ERA service delivery, electronic payments can be linked and delivered in tandem to ease provider reconciliation. Emdeon epayment delivers the flexibility and comprehensive approach needed to meet your complex payment needs Emdeon provides versatile and broad remittance options Emdeon epayment ERA Suite Payer Generated 835 ERA distributes a payer-generated 835 ERA to providers thru Emdeon s extensive distribution channel. When paired with our EFT service delivery, the 835 ERA can be linked and delivered in tandem to ease provider reconciliation. This simplifies provider reconciliation by enabling the addition of the issued ACH ID into the ERA data. Emdeon Generated 835 ERA distributes an Emdeon-created 835 ERA based upon payer supplied data elements. When paired with our EFT service delivery, the 835 ERA can be linked and delivered in tandem to ease Provider reconciliation. By leveraging our expertise and experience, Emdeon can help you please providers who are able to simplify account posting by utilizing your 835 ERA. EOP PDF Imaging displays a PDF image of the original printed explanation of payment (EOP) through Emdeon Payment Manager epayment Edition, which is provided free for the provider at the time of EFT service enrollment. This feature enables the provider to search, view and print their remittance statements online and without paper, delivering more savings to you. This functionality is included with any implementation of epayment EFT/ERA service and/or new payment services implementation. Contact Us Today! 877.EMDEON.6 ( ) At Emdeon, we re here to help. To transform the way you run your healthcare business today, call us at 877.EMDEON.6 ( ) for a complimentary review. 05

19 Emdeon epayment for Providers Emdeon epayment can help dramatically reduce expenses, shorten the reimbursement cycle and streamline workflow for providers through the broadest payer network in the market. With access to remittance data through Emdeon Payment Manager epayment Edition, epayment delivers valuable electronic payment and reconciliation processes to help providers eliminate paper checks, reduce costs and simplify secondary claims. This increase in efficiency can save time and allows many providers and staff to focus on reconciling outstanding payment issues to capture otherwise lost revenue. Whether the provider is a single provider office managing one bank account, or a large institution managing numerous bank accounts, Emdeon s new online enrollment tool makes setup simple and manageable. Enrolling to meet a provider s business requirements has never been easier. Once connected, providers save time with electronic funds transfers (EFTs), flexible delivery preferences and quick online access to remittance and payment information. Emdeon epayment can dramatically reduce expenses, shorten the reimbursement cycle and streamline workflow for providers We deliver the skills and solutions you need to provide better accountability of payments and help reduce the costs of retrieving overpayments Emdeon epayment Simplify payments and remittance with one partner Emdeon epayment simplifies payment and remittance distribution by providing the services you need through a single partner. World-class print and mail services, combined with efficient electronic delivery helps accelerate provider adoption while enabling reduced distribution and support costs. Our provider outreach initiatives help accelerate electronic adoption and shut off paper, and you can reduce costs by letting us handle provider enrollment. Activities Emdeon currently offers to help drive provider adoption include: Online Provider Enrollment Assistance and Management Healthpayers USA Postage Coop Educational Provider Webinars Informative Provider Communications Internal and Educational Messaging in Provider Solutions 24/ 7 Access for Providers to Emdeon Support Personnel Features Electronic deposit of claim payments to provider s bank Broad network of available payers Online EFT enrollment and account information Online self-service account management Flexible payment routing options Web-based search, view and print of payment and remittance information Downloadable ERA files from EFT-enabled payers The Emdeon difference Emdeon is your ideal partner for payment services because we offer the connectivity, experience and services to make your potential savings a reality. We deliver the skills and solutions you need to provide better accountability of payments and help reduce the costs of retrieving overpayments. The end result enables you to improve efficiency, lower costs and increase profitability. Benefits Reduced paper and printing costs Streamlined reconciliation process Detailed online payment visibility Fast, easy and secure payments No additional cost for EFT and ERA with participating payers Contact Us Today! 877.EMDEON.6 ( ) At Emdeon, we re here to help. To transform the way you run your healthcare business today, call us at 877.EMDEON.6 ( ) for a complimentary review. 07

20 Emdeon is a leading provider of revenue and payment cycle solutions that connect payers, providers and patients to improve healthcare business processes. To learn more about our company, our services and our commitment to improving healthcare, visit our website at Emdeon Business Services LLC. All rights reserved. EMDA rev Lebanon Pike, Suite 1000 Nashville, TN USA 877.EMDEON.6 ( )