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Emdeon Payment Integrity Solution Selected by HealthPlan Services

Focus on fraud, waste and abuse solutions by Emdeon gains momentum


News provided by

Emdeon Inc.

Jul 29, 2010, 08:30 ET

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NASHVILLE, Tenn. July 29 /PRNewswire-FirstCall/ -- Emdeon Inc. (NYSE: EM), a leading provider of healthcare revenue and payment cycle management solutions, today announced that HealthPlan Services (HPS) has selected its Payment Integrity Fraud Prevention Solution to further enhance HPS' comprehensive payer services. HPS is the nation's largest independent provider of service and technology solutions to the insurance and managed care industries, offering its clients the ability to leverage more than 40 years of industry expertise with business process solutions that increase efficiency, accuracy, membership retention and profitable growth.

Emdeon and HPS, which have had a longstanding strategic commercial agreement for healthcare transactions and payment distribution services for eight years, recently expanded their relationship to leverage Emdeon's payment integrity suite of solutions. Under the parties' new managed gateway agreement, Emdeon also will monitor claims for potential fraudulent activity prior to adjudication on behalf of HPS for more than 25 unique insurance companies and 32,000 businesses that cover 1.4 million members nationwide.

"Emdeon is positioned directly between healthcare providers and payers in the revenue and payment cycle workflow," said Gary Stuart, executive vice president of payer services for Emdeon. "Our position in the healthcare workflow allows Emdeon to offer innovative Payment Integrity Solutions designed to proactively prevent fraud, waste and abuse as opposed to other market products that are limited to post-payment recovery methods."

Emdeon Payment Integrity Solutions employ innovative fraud detection tactics to deliver a holistic solution that integrates emerging technology and data-driven analytics to help prevent lost healthcare dollars. Losses due to fraud, waste and abuse are estimated at 2-10 percent or more of the $2.4 trillion spent on healthcare in the U.S. today. At the high end of this range, that would translate to an estimated $10 per $100 of healthcare dollars spent on fraud.

"HPS' services are specifically designed to meet the needs of payers insuring individuals and small businesses," said Jeff Bak, president and chief executive officer of HPS. "By expanding our relationship with Emdeon, we can help those payers ensure legitimate claim payments without the business impact of unnecessary retrospective re-work."

As an industry reference, Emdeon has published a white paper titled "Payment Integrity: New perspectives on, and approaches to, mastering the challenge of healthcare fraud, waste and abuse." The white paper explores the history, trends and challenges of preventing healthcare fraud and can be downloaded for free at http://www.emdeon.com/pdfs/EMDA1010235.pdf.

About Emdeon

Emdeon is a leading provider of revenue and payment cycle management solutions, connecting payers, providers and patients in the U.S. healthcare system. Emdeon's product and service 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 products and services, 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 process. For more information, visit www.emdeon.com.

About HealthPlan Services

HealthPlan Services (HPS), a Water Street Healthcare Partners affiliate, is the largest independent provider of service and technology solutions to the insurance and managed care industry. Since 1970, HPS has offered customized administration and distribution services to insurers of individual, small group, voluntary and association plans, as well as providing valuable solutions to thousands of brokers and agents that sell into this market. HPS' proprietary, scalable technology provides innovative consumer-facing solutions that are turnkey self-service tools for our insurance carriers and distribution partners. HPS offers an ever-expanding array of services to a diverse and growing client base, and administers products that include medical (PPO, HMO, indemnity, consumer-driven), dental, vision, life, disability, cancer, critical illness, accident, long term care, limited medical, as well as various other ancillary insurance. HPS is committed to providing extraordinary service to its customers. For more information about HPS, visit www.healthplan.com.

Statements made in this press release that express Emdeon's or management's intentions, plans, beliefs, expectations or predictions of future events are forward-looking statements, which Emdeon intends to be covered by the safe harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. These statements often include words such as "may," "will," "should," "believe," "expect," "anticipate," "intend," "plan," "estimate" or similar expressions. Forward-looking statements may include information concerning Emdeon's possible or assumed future results of operations, including descriptions of Emdeon's revenues, profitability and outlook and its overall business strategy. You should not place undue reliance on these statements because they are subject to numerous uncertainties and factors relating to Emdeon's operations and business environment, all of which are difficult to predict and many of which are beyond Emdeon's control. Although Emdeon believes that these forward-looking statements are based on reasonable assumptions, you should be aware that many factors could affect Emdeon's actual financial results or results of operations and could cause actual results to differ materially from those in the forward-looking statements, including the risks discussed in the "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" sections and elsewhere in Emdeon's Annual Report on Form 10-K for the year ended December 31, 2009, as well as Emdeon's periodic and other reports, filed with the Securities and Exchange Commission.

You should keep in mind that any forward-looking statement made by Emdeon herein, or elsewhere, speaks only as of the date on which made. Emdeon expressly disclaims any intent, obligation or undertaking to update or revise any forward-looking statements made herein to reflect any change in Emdeon's expectations with regard thereto or any change in events, conditions or circumstances on which any such statements are based.

SOURCE Emdeon Inc.

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