Emdeon Announces Expanded Payment Integrity Solutions and Educational Presentations During NHCAA

Healthpayers Protect™ enables smarter payments by preventing improper claim payments prior to disbursement

Nov 14, 2011, 08:30 ET from Emdeon Inc.

NASHVILLE, Tenn., Nov. 14, 2011 /PRNewswire/ -- Emdeon Inc., a leading provider of healthcare revenue and payment cycle management and clinical information exchange solutions, today announced the expansion of its Payment Integrity Solutions. The expanded solutions will offer healthcare payers new options that analyze adjudicated claims before they are paid to help prevent improper payments.

Emdeon provides comprehensive and innovative payment integrity solutions that span the entire revenue and payment cycle, from pre-adjudication to post-payment, to help prevent fraud, waste and abuse. These solutions utilize advanced analytics and investigative detection capabilities, as well as audit and recovery services, in an effort to empower payers of all sizes to intelligently automate processes that previously required a significant investment in human resources and IT infrastructure. The launch of Healthpayers Protect complements Emdeon's existing payment integrity solutions with a final claims review that helps to identify payments with readily apparent coding issues or invalid provider data, all without delaying valid provider reimbursements.  

"In a time where payers are under immense pressure to control costs, our payment integrity solutions can offer the payer community immediate benefits with minimal investment," said Gary Stuart, executive vice president for payer services for Emdeon. "Emdeon's vast data network, position in the healthcare workflow and sophisticated analytics can help streamline claim settlements and ultimately enhance the payer and provider relationship. Healthpayers Protect is a natural product extension to our existing payment services customer base of more than 800 payers."

To further enhance its comprehensive Payment Integrity Solutions, Emdeon recently entered into an agreement with TC(3) Health, Inc., to seamlessly integrate TC(3)'s TruClaim(sm) Provider Integrity Program, a proprietary claims cost management suite, into  Emdeon's Payment Integrity Solutions. This added functionality will help simplify implementation of fraud detection and claims editing and make it easier for payers to customize a solution to best meet their needs.

Emdeon will exhibit its Payment Integrity Solutions, including Healthpayers Protect, at the National Health Care Anti-Fraud Association (NHCAA) conference in Atlanta from November 15-18, 2011.  Emdeon will also present short, impactful educational sessions at Emdeon's in-booth theater (booth 200) and host a breakfast symposium, which features Emdeon and other healthcare industry experts. For more information on Emdeon at NHCAA, please visit www.Emdeon.com/2011NHCAA.

Making Every Dollar Count: Tools and Technology to Optimize the Special Investigative Unit (SIU)

A Breakfast Symposium, Hyatt Regency Atlanta Room Hanover AB

  • Thursday, November 17th at 7-8:30 am


  • Thomas P. Brennan, Jr., AHFI Consultant, Former Director, SIU for Highmark BCBS and past NHCAA president
  • John Shoemaker, MBA, CFE, CPA  Manager, Financial Investigations Department, Medical Mutual of Ohio
  • Kyle Cheek, Ph.D., Vice President, Data and Analytics, Emdeon
  • Moderator - Mark Isbitts - Director, Product Management, Emdeon

Underfunded? Lack resources? Need different technology? Many SIU personnel say they cannot effectively fight Fraud, Waste and Abuse (FWA) using existing systems and processes. Lost healthcare dollars, lean budgets and a constrained economy all drive the need to make every dollar count. To maximize program benefits, attack the problem on several fronts – before and after claim adjudication. The most effective solution is a holistic one that integrates advanced technology, innovative tools, expansive data and experienced SIU support staff. This approach can help optimize results, combining single solution focus with the power of collective data and numerous "safety nets." Discover how comprehensive payment integrity can help make every dollar count.

Executive Briefs Held at Emdeon Booth 200

These 10-minute sessions offer a quick topic overview and a chance to learn more from Emdeon executives.

Predictive Analytics and the SIU: Separating Fact from Fiction

  • Tues, November 15th at 5:30 pm and Wed, November 16th at 5:30 pm

Predictive analytics are a hot topic, but not everyone agrees what they are and how they work. Find out how predictive analytics are truly changing the SIU landscape.

The Emdeon Difference: How Better Data is Revolutionizing the SIU

  • Tues, November 15th at 6:15 pm and Wed, November 16th at 6:30 pm

Discover how Emdeon's access to over five billion healthcare transactions annually can create more savings opportunities than ever before.


  • Kyle Cheek, Vice President, Data and Analytics, Emdeon
  • Adam Hameed, Senior Vice President, Data and Analytics, Emdeon
  • Terry Cameron, Senior Vice President, Payment Integrity Services, Emdeon
  • Kurt Anderson, Senior Vice President, Business Development and Marketing, Emdeon

About Emdeon

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. Emdeon's offerings integrate and automate key business and administrative functions of its payer and provider customers throughout the patient encounter. Through the use of Emdeon's comprehensive suite of solutions, which are designed to easily integrate with existing technology infrastructures, customers are able to improve efficiency, reduce costs, increase cash flow and more efficiently manage the complex revenue and payment cycle and clinical information exchange processes. For more information, visit www.emdeon.com.

SOURCE Emdeon Inc.