POWERFUL CHANNEL PARTNER SOLUTIONS

Transcription

1 POWERFUL CHANNEL PARTNER SOLUTIONS Simplifying the Business of Healthcare

2 ONE PARTNER CAN HELP YOU OFFER YOUR CLIENTS MORE COMPLETE REVENUE CYCLE SOLUTIONS... ENHANCE YOUR PARTNERSHIPS TABLE OF CONTENTS p.3 Partnership Options p.4 Eligibility & Benefits p.6 Clinical Management p.8 Claims & Payment Management p.12 Patient Billing & Payment p.14 Channel Partner Support Tools Contact Us Today! 877.EMDEON.6 ( ) Partnership Options 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.

3 Smart, flexible partnership solutions that integrate with your business goals Emdeon is a leading provider of transaction processing and revenue cycle management services that enable partners to more effectively compete and grow their business. Emdeon wholesales a full range of private-label financial and clinical communication services to practice management system, electronic medical record and revenue cycle management system vendors. Emdeon s partners benefit from the cost advantages provided by Emdeon s scale as well as Emdeon s continuous investment in payer connectivity and provider-facing, private-label products and services. Emdeon offers several partnership programs, each of which is designed to help increase your revenue and improve your bottom line. We are committed to partnering with you to meet the increasingly complex demands of revenue cycle management with a comprehensive service and product offering. Standard Channel Partner Program Our base level program gives you access to the nation s largest healthcare revenue and payment cycle network. By leveraging Emdeon s network your customers will directly connect to more payers more efficiently with fewer chances of transmission errors. Enhanced Channel Partner Program This program builds on the standard level for vendors that want to maximize revenues and connectivity, while reducing their costs. This program is ideal for vendors that want to integrate multiple products and services with Emdeon. Partnership includes marketing support and increased revenue sharing. Premium Channel Partner Program In addition to what you get with the Standard and Enhanced programs, this level gives you access to Emdeon s all-payer network under the most beneficial financial terms including maximum revenue sharing opportunity. Ideal for vendors who want to fully integrate Emdeon s services and take advantage of all of Emdeon s available services for channel partners. This level offers dedicated marketing assistance to maximize your growth opportunities. 03

4 Eligibility & Benefit solutions that directly connect to the largest payer network Emdeon leads the industry in clearinghouse and EDI solutions for automated EDI workflow that decreases electronic claims receipt and pre-processing cost; reduces phone calls from providers and improves your auto-adjudication rate. Our secure transmission platform and HIPAA translations and formats offer you the best, and most reliable connectivity services available so that claims are processed correctly. Our nationwide electronic network allows us to connect to any system for all payer-to-provider HIPAA-mandated transactions. What are the advantages of an Emdeon partnership? One partner for all EDI services Connectivity to the largest network of commercial and government payers Full suite of EDI services including eligibility and benefits, claim status, find provider, healthcare services review request and response, healthcare services review inquiry and response and claim financial inquiries High scalability and reliability for quick responses at any level Seamless integration into existing systems and workflow What advantages are there for providers? Full suite of EDI solutions through one vendor Increased claim acceptance rates Productive and efficient workflow Connection to the most payers in the industry Emdeon is CORE certified. To demonstrate our commitment to improving administrative data exchanges, Emdeon certifies that we can exchange electronic healthcare administrative data according to the CAQH Committee on Operating Rules for Information Exchange (CORE) Phase II rules. How CORE rules help providers: Automate electronic eligibility and benefits inquiry processes more fully Receive consistent electronic information about patient deductible balances from potentially any health plan at the point of care Check the status of a claim and/or confirm payer organization receipt of the claim electronically Enhance patient matching to uniquely identify individuals Facilitate interoperability across healthcare information exchange with electronic connectivity 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. CORE, the CORE-certification/Endorser Seals and logo are trademarks of CAQH Copyright 2007, Council For Affordable Quality Healthcare. All rights reserved.

5 Emdeon Direct Connect brings together our industry leading clearinghouse and EDI solutions to reduce phone calls and improve auto-adjudication rates. Emdeon Direct Connect provides network connection via the HIPAA standard ANSI X12N format. Emdeon Direct Connect provides network connection supporting claims and encounter submission (837), electronic remittance advice (835), eligibility and benefits (270/271), claim status (276/277), healthcare services review request and response (278 X094), healthcare services review inquiry and response (278 X059) and claim financial inquiries (277/835). Powerful reporting capabilities Batch or real-time submission options Secure electronic transmission Decreases pre-processing costs Increases overall efficiency Emdeon Revenue and Reimbursement Analytics deliver automated batch screenings of patient account information so providers capture more revenue both before and after patient visits. These unique services leverage all available patient data to search for key information in government programs and payer databases resulting in increased revenue collection and reduced bad-debt write-offs for improved provider profitability. Using logic driven searches that are tailored to each providers needs and information on state specific search requirements, Emdeon returns user-friendly reports with details on benefits eligibility, pre-authorizations, address verification and claim status to give providers the information needed to maximize revenue collection opportunities. Increase revenue Patient address verification Reduce instances of incorrect or missing data Streamline the registration process Assist in improving up-front collections Emdeon Office is a web-based solution providing real-time patient data access and professional claims processing at a low cost. It instantly connects to the largest network of commercial and government payers in the industry to provide a wealth of real-time patient information. Web-based insurance eligibility and authorizations/precertifications Batch or real-time submission options Ensures HIPAA compliance Improves reimbursement rates Increases staff productivity 05

6 Clinical Management can jump to a new level with innovative and simplified connectivity Solutions that work the way providers do Efficient clinical management, that blends easily with everyday tasks, helps providers to be more productive. Emdeon s goal is to help you consolidate electronic lab ordering, results distribution and eprescribing into a single solution that can save providers time and money. Meaningful Use is easy with our Web-based EMR Lite and integrated health information exchange services eprescribing, CPOE and electronic results Unlimited clinical messaging among physicians, hospitals, labs and consumers Ability to integrate with EMRs Eligibility, claims and other administrative information exchange Money back guarantee* Provide reliable, quality information The extensive Emdeon network taps some of the most comprehensive databases available and provides a robust backbone capable of processing millions of secure transactions per day. This means that providers obtain accurate and secure information when they need it. Add valuable clinical connectivity Our solutions act as a hub joining tens of thousands of labs, hospitals, physicians and pharmacies through the power of the Internet. Providers can manage orders or prescriptions electronically from numerous labs and pharmacies and then respond, print and distribute results or reports at any time. 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. *Terms and conditions apply.

7 Emdeon Clinician connects physicians, pharmacies, laboratories, hospitals and payers through the most comprehensive web-based clinical ordering solution available. Providers can increase patient safety by reducing handwriting mistakes and electronically tracking reports. Access reports from any Internet connection Streamlines report delivery and management Generates cumulative reports to spot trending Joins hospital and lab reports into one location Emdeon ClinicianRx is the eprescribing module of Emdeon Clinician that utilizes web-based, electronic prescribing tools to increase patient safety and save time. Using a PDA or secure Internet browser, providers have access to medication histories, drug formularies and more at the point-ofcare. We also take care of getting certifications and updates for RxHub or Surescripts, so you and your provider clients have less to worry about. Simple ordering of refills and new prescriptions Improves patient safety Ensures correct dosages Improves formulary compliance Emdeon erx Network eprescribing allows your physician customers to directly exchange secure electronic prescribing transactions with a rapidly growing list of pharmacies nationwide. By connecting to erx Network, you can give your providers direct access to an expansive list of pharmacies nationwide. This direct connectivity will not only increase practice efficiency but will also result in a more streamlined, efficient flow of information between your physicians and pharmacies that have designated erx Network as their preferred electronic prescribing network. Prescriptions are delivered directly to pharmacy management systems on the Emdeon network. Pharmacies conveniently access physicians through the Emdeon Provider Directory. Direct Routing Advantages: Streamlines communications between pharmacist and physician Increased reliability, exceptional value erx Intelligent Routing TM determines the most efficient route to physicians and pharmacies Expert support for all current versions of NCPDP SCRIPT Integrated erx CardFinder TM Centralized electronic faxing service 07

8 Claims & Payment Management solutions provide end-to-end visibility into the claims life cycle Emdeon leads the industry in clearinghouse and EDI solutions for automated EDI workflow that decreases the cost of electronic claims receipt and pre-processing; reduces phone calls from providers and improves your auto-adjudication rate. Our secure transmission platform and HIPAA translations and formats offer you the best, and most reliable connectivity services available so that claims are processed correctly. Our nationwide electronic network reach allows us to connect to any system for all payer-to-provider HIPAA-mandated transactions. Faster adjudication and shorter billing cycles result in increased cash flow for providers. An Emdeon partnership offers the broadest payer connectivity and helps eliminate time-consuming paper processes so providers can focus their energy on their patients. HIPAA simplified with Emdeon As part of Emdeon's commitment to guiding our clients through the transition to HIPAA X12 Version 5010 standards, we have completed a thorough gap analysis between versions 4010A and 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets. We are on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA X12 Version 5010 standards. We have several resources available to assist our customers in the transition. 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.

9 What are the advantages of an Emdeon partnership? One partner for all EDI services Single point of connectivity to over 1,200 national, regional and government payers for claim submission and processing Online claim tracking to better support your providers Pre-adjudication logic applied to claims for increased first pass acceptance rates High scalability and reliability for quick responses at any level Flexible file-type submission Seamless integration into existing systems and workflow What advantages are there for providers? Faster adjudication + shorter billing cycles = increased cash flow Increased claim acceptance rates Centralized online claims management tool empowering providers to self-help Interactive dashboards enabling providers to analyze claim rejection trends Productive and efficient workflow Connection to the most payers in the industry Emdeon Direct Connect brings together our industry leading clearinghouse and EDI solutions to reduce phone calls and improve autoadjudication rates. Emdeon Direct Connect provides network connection via the HIPAA standard ANSI X12N format. Emdeon Direct Connect provides network connection supporting claims and encounter submission (837), electronic remittance advice (835), eligibility and benefits (270/271), claim status (276/277), healthcare services review request and response (278 X094), healthcare services review inquiry and response (278 X059) and claim financial inquiries (277/835). Powerful reporting capabilities Batch or real-time submission options Secures each electronic transmission Decreases pre-processing costs Increases overall efficiency 09

10 Emdeon Vision for Claim Management is a powerful, web-based application that gives Emdeon channel partners complete visibility into their clients claims filing process. Emdeon Vision provides your customer service staff with an end-to-end view into all claims from the point of submission to Emdeon through payer adjudication. The powerful search capabilities allow users to quickly locate a claim and determine its status with user-defined search criteria. Additionally, Emdeon offers a version of Emdeon Vision to providers allowing providers to self-help. With Emdeon support, you and your providers using the same claim management tool the speed of problem resolution is greatly increased. Optional customer branding Track claims as easily as tracking a package online via our secure web portal or via your mobile smartphone Exposes key rejection trends for correction Integrates into virtually any customer service application Submit Workers' Compensation and Auto-Medical Bill attachments electronically Quick analysis of rejection trends within your practice and in comparison to others within your vendor community Emdeon Office is a web-based application that provides real-time patient data access, professional claims processing and electronic prescribing tools at a low cost. It instantly connects to the largest network of commercial and government payers in the industry to provide a wealth of real-time patient information and health information exchange. Anytime, anywhere web-based access Fast, easy end-to-end claim tracking Batch or real-time submission options Reduces errors and maximizes reimbursement rates Improves productivity through helpful automation Eliminates paper and phone communications Contact Us Today! 877.EMDEON.6 ( ) Providers who use Emdeon Vision will also have access to their claim data on their mobile smartphone. 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.

11 Emdeon Revenue and Reimbursement Analytics delivers automated batch screenings of patient account information so users capture more revenue before and after patient visits. This service leverages all available patient data to search for key information in government programs and payer databases resulting in increased revenue collection and reduced bad-debt write-offs for improved provider profitability. Screens patients before and after visits Retroactively identifies insurance coverage Patient address verification Increases revenue Reduce instances of incorrect or missing data Emdeon Payment Manager is an electronic payment and reconciliation solution that increases visibility of remittance data and facilitates the electronic transfer of funds from the largest payer network in the industry. By coupling electronic remittance information with electronic claims payments, Emdeon Payment Manager shortens the reimbursement cycle, dramatically reduces expenses and streamlines workflow by automatically interpreting Electronic Remittance Advice (ERA) received from government and commercial payers. Providers can use their access to the Emdeon s extensive payer network to automate the secondary billing cycle for payers that offer ERA. User-friendly, web-based tools for viewing electronic and paper remittances and payments Electronic deposit of claims payments to any bank Enables providers to reduce costs and improve efficiency by moving to a paperless payment process Helps reduce errors in patient information Streamlines your providers revenue cycle processes 11

12 Patient Billing & Payment solutions accelerate the billing process and help providers efficiently manage receivables Emdeon offers a multitude of ways to manage patient billing and receivables. We are one of the largest patient statement processors in the country and offer a multitude of electronic presentment options that take full advantage of our EDI expertise. This gives your providers the ability to accelerate reimbursement with cost-effective services ranging from efficient printing and mailing of patient statements to advanced online payment options. Prompt faster payments with clear, efficient billing The patient bill is an important communication that should reflect the accuracy and quality of care that each provider represents. Our statements encompass HFMA s PATIENT FRIENDLY BILLING guidelines so they are produced quickly and cost-effectively. With a clean, professional appearance, our easy-to-understand statements can reduce customer service calls and prompt faster payments. PATIENT FRIENDLY BILLING is a registered trademark of HFMA What advantages does Emdeon offer? Fast, cost-efficient billing PATIENT FRIENDLY BILLING formats Professionally created patient statement inserts Online bill presentment and payment Fewer calls from patients to providers Accelerate the revenue cycle with online billing solutions Online bill presentment and payment options can accelerate payments by making the process easier for everyone. Patients can conveniently pay at any time and providers can work in larger blocks of time without interruption. Emdeon Patient Connect is a comprehensive, integrated solution that simplifies your providers patient billing and payment process with a single patient payment platform for all paper and electronic billing and payments. Our print, online and point-of-service collection suite addresses the challenges associated with billing and collecting patient receivables resulting in increased self-pay collections, improved operational efficiencies and reduced administrative costs. 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.

13 Emdeon ExpressBill Services provides state-of-the-art statement and invoice processing for fast delivery of accurate patient communications. We tap the power of your providers billing database to create and deliver personalized patient statements. Emdeon ExpressBill Services encompasses the guidelines of HFMA s PATIENT FRIENDLY BILLING and focuses on improving the quality of patient statements. Emdeon Return Mail Manager saves time and speeds collections by eliminating 100% of return mail handling. The cost of undeliverable mail is expensive and can be a significant burden for providers. Instead of returning to you or your providers facility, all returned mail goes directly to our processing center where it is analyzed to find updated address and delivery information. Emdeon Patient Lockbox automates the process of sorting, opening, posting, depositing and managing patient payments to improve cash flow and optimize operational efficiencies. Using Emdeon Patient Lockbox in conjunction with Emdeon Patient Connect enables providers to have one single system to bill, track and receive all paper and electronic patient payments. Emdeon Patient Pay Online is a patient facing application that provides comprehensive and secure online billing and payment management. Emdeon Patient Pay Online facilitates faster collection of patient-owed amounts, improved cash flow and reduced billing costs, all with less effort and paperwork. Emdeon ecashiering simplifies the payment collection process by providing an enterprise-wide approach to collecting patient payments. Each day s payment activity is automatically posted directly to your providers financial system. Emdeon Merchant Services is a secure and reliable debit and credit card processing solution that can actually reduce the cost of accepting patient payments. By providing direct access to the leading credit card networks and routing transactions more efficiently, Emdeon Merchant Services can help your providers keep more of what they collect. Emdeon Document Archive provides options for providers to view and retrieve indexed billing files from their desktop 24/7. It enables providers to respond quickly to patient billing queries, encourages faster payments and reduces document storage costs. 13

14 Channel Partner Support Tools add valuable tools for providers to efficiently manage the revenue cycle State-of-the-art support systems help us to better serve our business partners and their provider clients. These support tools enhance revenue cycle management by allowing for autonomy and simplifying communications. Our partners and their clients can quickly track down issues on their own. At the core of these services is our desire to deliver industry-leading support that can result in the most efficient and costeffective revenue cycle management possible. We understand the competitive nature of this industry and have enhanced our solutions in ways that will give you a clear advantage. Get the support you expect Emdeon ON24/7 means just what it says: support tools and services are available to you 24 hours a day, seven days a week. With Emdeon ON24/7 you ll have access to highly trained support personnel via the Internet. Our support services cover all our customers and we deliver the familiarity, transparency and accuracy you need for issues to be solved clearly and quickly across multiple facilities. You ll be connected with people who understand your systems, your business and your staff. Interact with Emdeon staff via the web or on the phone Review Frequently Asked Questions Create and track status of Service Requests any time, anywhere Proactive targeted alerts about payer availability, uptime and other key information so you are aware of problems before your providers contact you for help Detail issues in your own words for clearer communication Consolidate updates, alerts and tips into one easy-to-access location. 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.

15 Providers can be more independent With our web-based claim reporting tool, Emdeon Vision for Claim Management, you have complete visibility into your client s electronic claim filing process. Emdeon Vision for Claim Management enables you to easily perform claim searches, quickly verify a claim s status and securely control customer access. You ll get a complete end-to-end view into the claim cycle, from provider submission all the way through adjudication, empower your customer service staff with the same claim views available to payer organizations. Powerful search capabilities help you quickly locate a claim and track it through its life cycle with your own user-defined search criteria. In addition, our Emdeon Internet Transaction Services (ITS) simplify communications. Using this service, healthcare providers can send and receive all major HIPAA compliant healthcare EDI transactions and patient statements with one comprehensive communications protocol suite and a single universal ID. Enrollment is easy Our automated enrollment program enables clearinghouse services customers to directly manage provider enrollments in our support services without the need to manually send paper forms to Emdeon. In just a few minutes, you can enroll individual, group and institutional providers, as well as enter the status of Trading Partner agreements with government payers. Full service support solutions With Emdeon s full service offering, we will handle provider enrollment support, and perform initial, first-level support directly with your providers with respect to all Emdeon Services. Providers will also have access to our ON24/7 support monitoring tool and Emdeon Vision for Claim Management for their claim tracking. Emdeon s full service support solutions give providers the fastest path to resolution when there is an issue. Emdeon is fully dedicated to providing superior support to all of our customers. In fact, even our CEO has a real-time support monitoring system in his office so he s able to keep a watchful eye on all activities, from billing and reporting to product functions and service. The monitoring tool can not only identify problems, but track patterns and take fast action to implement solutions notifying the business owner if there s an issue. 15

16 Elevate your level of business through an Emdeon Channel Partnership When you partner with Emdeon you not only get the powerful, flexible solutions today s providers require, but you get them all from a single source. As your business grows, Emdeon will be there to show you the most innovative and valuable ways to build your business. Our solutions can help by bringing together endto-end revenue cycle management, accurate clinical solutions and valuable channel partner support tools into one source to provide the consistency, reliability and accountability you expect from a long-term business partner. Discover the benefits of a partnership with Emdeon. Call today and start building a competitive edge through the comprehensive support, products and services that providers need to simplify the business of healthcare. We invite you to contact us and discover solutions that Simplify the Business of Healthcare 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 Maximize Your Product Offerings with an Emdeon Partnership Connectivity. Simplicity. Innovation. Control. Advantage. Timely provider reimbursement and compliance is something your clients look to you to deliver. This requires simple and efficient payer interactions. Through Emdeon s unique suite of allpayer services, you can offer your providers a comprehensive solution to simplifying the entire revenue cycle. Emdeon is fully committed to the success of our channel partners and providers. 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 ( ) vendorsales@emdeon.com