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Member Management Solutions
Emdeon Member Management offers a unique upstream approach for efficient management and utilization of member eligibility data that achieves downstream administrative and medical cost savings. Our suite of member information-driven solutions helps payers strengthen provider self-service, improve member care management, increase auto-adjudication rates, comply with government benefit reporting mandates and facilitate HIPAA and CORE compliance. |
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Claims Management Solutions
Emdeon's Claims Management solutions offer the expertise of an organization with nearly two decades of experience in the healthcare claims processing industry. Emdeon leads the industry in eServices solutions for automated EDI workflow that decrease electronic claims receipt and pre-processing costs; reduce phone calls from providers and improve your auto-adjudication rates. |
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Payment Management Solutions
Emdeon is the industry's leading provider of payment distribution services, with the ability to deliver payments both electronically and on paper (print and mail). EOBs, ERAs, EFTs and document distribution—Emdeon's flexibility makes it the premier solution for healthcare payers and third-party administrators. |
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Care Management Solutions
Emdeon Care Management services leverage Emdeon’s existing electronic connections to provide total member population health engagement and care intervention strategies. Our industry-leading electronic healthcare information network, along with our printing services that distribute healthcare communications to over 150 million patients in the United States, enables Emdeon to offer services that increase the benefits of sharing health information before and after the patient encounter. |
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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. Our flexible, innovative solutions easily integrate with your existing claims workflow and can be tailored to meet both immediate and future needs. Emdeon can help you be confident that when you pay a claim, it's a payment worth making. |
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Prescription Benefit Administration
Emdeon Prescription Benefit Solutions allow payers to in-source their prescription benefit program to obtain real transparency and improve their Medical Loss Ratio. Emdeon can tailor our services to provide as much assistance as your organization needs. |
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