On January 16, 2009, the U.S. Department of Health and Human Services (HHS) published rules that require updated versions of the standards for electronic transactions under the authority of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These updated standards (Versions 5010 and D.0) are designed to replace the current standards (Versions 4010/4010A1 and 5.1) and are designed to promote greater efficiency in electronic transactions. Compliance with the new HIPAA 5010 and NCPDP D.0 standards is required by January 1, 2012.
This transition poses a number of challenges for covered entities which are defined as businesses that are required to achieve compliance in large part because these changes affect all healthcare segments: hospitals, physicians, dentists, pharmacies, PBMs, payers and vendors.
In December 2009, Emdeon Senior Vice President of Corporate Strategy and Government Services, Miriam Paramore, testified before the National Committee on Vital and Health Statistics (NCVHS). During her testimony, Paramore said, “Emdeon is committed to supporting our customers and leading the industry in compliance and adoption of the new standards and code sets.” She continued, “Our goal is to be ready in advance of the government mandated deadlines to ensure a smooth and successful transition.”
On January 22, 2010, Emdeon launched HIPAA Simplified to be a one-stop resource for the information that covered entities needed for HIPAA readiness. HIPAA Simplified will be a communications focal point as Emdeon helps its customers adopt the 5010 and D.0 standards prior to 2012. The website offers technical gap analyses, simplified business-level downloads, trading partner transition strategy information, frequently asked questions and testing tools.
Additionally, HIPAA Simplified is divided by business units across the entire healthcare industry, eliminating the need for complex web navigation or surfing multiple sites. Visitors simply select their line of business and all available resources are located on the page to browse and download. For free.
What really sets HIPAA Simplified apart from other resources, however, is its analytical tools that are designed to propel the transition strategies of covered entities. Only HIPAA Simplified offers informational and analytical tools, from high-level FAQs, to documents that explain the transition in business-level language, to in-depth technical analyses.
As the nation’s largest health information network, Emdeon is the healthcare industry’s most comprehensive source for HIPAA readiness. Just as with HIPAA 4010 and the National Provider Identifier (NPI), Emdeon is working diligently to deliver solutions that enable its customers to seamlessly meet the new requirements for HIPAA 5010, NCPDP D.0, and ICD-10.
Make sure to spread the word and bookmark www.hipaasimplified.com– it will be updated often as the compliance deadline approaches.
HIPAA Simplified
Emdeon recommends secure interim solutions to avert delays in the implementation of ePrescribing of controlled substances
Emdeon Submits Comments to DEA on Interim Final Rule
NASHVILLE, Tenn., May 27 /PRNewswire-FirstCall/ -- Emdeon Inc. (NYSE: EM), a leading provider of healthcare revenue and payment cycle management solutions, today submitted formal comments to the U.S. Drug Enforcement Administration (DEA) in response to the agency's request for comments on the Interim Final Rule enabling electronic prescribing (ePrescribing) of controlled substances. Emdeon's comments reiterate its support for the proposed security standards and recommend the DEA consider interim solutions to permit implementation as soon as possible after the Final Rule becomes effective on June 1, 2010.
As the only ePrescribing network with market-based experience, Emdeon through its eRx Network is already demonstrating the achievability of ePrescribing of controlled substances and its potential impact on healthcare. Emdeon is participating in a multi-year research project with the Massachusetts Department of Public Health (MDPH) for ePrescribing of controlled substances. The project began in 2007 and Emdeon believes the lessons learned can assist in developing implementation guidelines for the Final Rule within existing workflows, standards, certifications and technology changes.
"ePrescribing in general, and specifically ePrescribing of controlled substances, can bring several benefits to physicians, pharmacists, patients and the health system as a whole," said George Lazenby, chief executive officer of Emdeon. "Emdeon wants to do everything we can to support nationwide implementation of ePrescribing of controlled substances as soon as possible."
ePrescribing of controlled substances is expected to help overcome the last major barrier preventing certain physicians from ePrescribing as they will no longer have to maintain both paper and electronic workflows. Emdeon believes another benefit of ePrescribing of controlled substances to pharmacies, hospitals and practitioners will be the added level of security for controlled substance prescriptions that come with the new DEA regulations.
Emdeon's comments, which are both supportive and constructive, focus on the provisions that require a secure transmission of electronic prescriptions, including provisions relating to digital signature indicators and digital signatures; signing and transmitting prescriptions; content alteration and two-factor authentication. Emdeon's comments note that it believes the industry will take a significant amount of time to adopt and implement formal standards that address all parts of the Final Rule and suggests the DEA consider interim guidelines to support adoption variances. Emdeon believes such variances would permit quicker adoption while allowing the industry sufficient time to develop and implement long-term infrastructure to meet the minimum requirements of the Interim Final Rule.
"Security and data integrity are the most important factors driving the future success of ePrescribing of controlled substances," said Rick Sage, Emdeon's vice president of clinical services and the manager of Emdeon's participation in the MDPH research project. "Working in conjunction with our partners in the MDPH project, we successfully implemented a workable solution for electronic data transmission security. While the Interim Final Rule mandates some specific requirements that differ from the MDPH project, there are certainly enough similarities that will enable Emdeon to readily assist our partners in implementing and complying with the Final Rule."
Emdeon estimates only approximately 18% of all prescriptions are currently transmitted electronically. According to the Centers for Medicare and Medicaid Services, adoption of ePrescribing can enable improvements in patient safety, quality of care and cost effectiveness. ePrescribing can reduce the need to retype medication and dosage information, helps to eliminate the need for interpretation of prescriber handwriting and potentially reduces the amount of labor required to approve and fill any given prescription.
Emdeon's secure and interoperable network is the largest financial and administrative healthcare information exchange in the nation. Clinical exchange volumes among Emdeon's suite of solutions are increasing with a current annual run rate of 100 million ePrescriptions and 30 million clinical messages per year. In total, Emdeon currently facilitates over 5 billion healthcare information exchanges each year through its network which reaches approximately 500,000 physicians, 81,000 dentists, 55,000 pharmacies, 5,000 hospitals and 1,200 payers.
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, its 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.
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 of 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.
Emdeon acquires FutureVision Technologies to enable full automation of healthcare payments
Acquisition combines Emdeon's broad connectivity network and revenue cycle management solutions with FVTech's innovative suite of payment transformation solutions
Emdeon announced January 26th the acquisition of FutureVision Technologies ("FVTech"), a premier provider of outsourced services specializing in electronic data conversion and information management solutions. By combining FVTech's innovative document conversion technology with Emdeon's broad connectivity network and revenue cycle management solutions, Emdeon will now have the ability to electronically process virtually all patient and third-party healthcare payments regardless of the format in which the payments are submitted.
Commenting on the strategic benefit of the acquisition, George Lazenby, chief executive officer of Emdeon said, "Today, roughly 90% of payments in healthcare are conducted via paper. At Emdeon, we are committed to changing this fact. FVTech's technology, when combined with our industry-leading all-payer network, will position Emdeon to help our customers overcome many of the barriers that prevent automation of these payments. With FVTech's capabilities, Emdeon can now automate 100% of the posting for both paper and electronic payments for our provider customers. These capabilities will allow Emdeon to create immediate savings for our customers through automation and help reduce costly errors that commonly occur through manual processes."
Brad Banyai, chief executive officer for FVTech, stated, "As a result of our acquisition by Emdeon, we can properly leverage our technology and experience with Emdeon's vast connectivity in the marketplace and make real inroads to processing healthcare payment transactions electronically. For more than ten years, FVTech has focused on creating electronic document solutions for the healthcare industry and we are excited about layering our solutions into the Emdeon network."
Emdeon currently distributes payments and remittance data to more than 500,000 healthcare providers. According to a November 2009 report by Celent, there could be as much as $11 billion in annual savings realized in the U.S. alone by converting paper checks and explanation of benefits to electronic data. FVTech's documentation conversion technology, when coupled with Emdeon's consumer payment processing services, will provide a comprehensive payment solution for providers. The new capabilities acquired as a result of the FVTech acquisition will also allow Emdeon to automate the posting of payments from its network along with other payer payments to automate this historically labor-intensive process. This 360 degree view of payments will offer healthcare providers the ability to manage 100% of their third party payer and consumer payments from one vendor, as well as automated reconciliation and posting capabilities.
To view the full press release or learn more about how Emdeon is Simplifying the Business of Healthcare, visit our website or call 877.EMDEON.6 (877.363.3666).
Read More >>
National Progress Report on healthcare efficiency: Introduction/ Executive Summary
The National Progress Report on Healthcare Efficiency is the first annual report on the findings from the primary research phase of the U.S. Healthcare Efficiency Index® (USHEI). The USHEI was launched in 2008 to raise awareness of the potential cost savings associated with adoption of basic electronic transactions in healthcare. In its first year, several important milestones were achieved including successful engagement with policy makers on the practical benefits of administrative simplification. The initial findings announced during the launch of the USHEI were based on a thorough analysis of available industry data. Phase 1 of the Index estimated total potential savings to be nearly $30 billion per year for medical claims-related transactions.
Over the course of the year that followed, the Advisory Council for the USHEI oversaw the development of a detailed methodology, a secure data collection infrastructure and a formal data collection process that is now yielding an initial set of data. This report places the findings in the context of the recently enacted healthcare reform legislation, as well as the HITECH Act, passed as part of the American Reinvestment and Recovery Act (ARRA). It assesses the landscape and suggests a set of trends likely to impact the healthcare industry in the months and years to come. Here is a summary of the key findings that will be discussed in this report:
1. The industry is making progress on adoption of electronic claims. The data shows a current rate of 85%, which represents a 10% increase over the Phase 1 findings.
2. Adoption of electronic remittance advice transactions is also higher. Data shows a current rate of 46% as compared to 26% in Phase 1.
3. Calculating the costs and potential savings associated with automation in healthcare has become increasingly complex, particularly as the lines get blurred between electronic and paper-driven offices.
4. Cost savings must be addressed at the system level. Approaching the problem as a systemic issue is critical to help avoid the continual cost shift that has plagued healthcare for so long.
5. Meaningful Use requirements are expected to drive further adoption of claims and eligibility transactions, assuming the requirements remain intact in the final rules. In general, the inclusion of revenue cycle transactions as a part of Meaningful Use illustrates the convergence of clinical and financial information which is an important trend in health information exchange.
6. The recent passage of landmark healthcare reform legislation brings significant gains in the area of administrative simplification by adding covered transactions like e-payment and requiring greater standardization and operating rules. This new policy will play an important role in eliminating many of the old barriers to adoption.
7. Implementation of healthcare reform will be a long and complex process. It will be important for all stakeholders to stay involved and ensure that their needs and concerns are reflected in the rules and regulations to be written in coming years.
8. Change is hard, but for the nation’s healthcare system, not changing will be much harder. With Medicare Trust Fund Reserves expected to be exhausted in less than 10 years (2017) and 41 states facing midyear budget shortfalls, it is critical to capture tangible savings today wherever possible.
Medicare
Based on its most recent report in 2009, Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures than it received in taxes and other dedicated revenues. Growing annual deficits are projected to exhaust reserves in 2017.
(From the SUMMARY OF THE 2009 ANNUAL REPORTS, Social Security and Medicare Boards of Trustees)
Medicaid
Mid-way through state fiscal year 2010, the effects of the economic recession (rising unemployment, sharp declines in revenues, higher demands for public programs, including Medicaid) continue to plague states… 41 states are facing
mid-year budget shortfalls for fiscal year 2010 that could total $35 billion. Looking to 2011, states estimate a budget gap of $102 billion but could grow to $180 billion as revenues continue to decline.
(From the Kaiser Commission on Medicaid & the Uninsured, Feb. 2010)
New and exciting enhancements to Emdeon Vision for Providers
Emdeon Vision(SM)for Claim Management is a real-time, web-based application for tracking and monitoring all claims submitted through Emdeon. Emdeon Vision gives you and your providers access to 15 months of historical claim data instantly at your fingertips. We’ve recently updated the provider-facing version of Emdeon Vision to improve workflow for your providers.
New enhancements include:
• Drop-down lists and improved navigation
• “My Practice” landing page presenting a summary snapshot of claims that may require your attention
• ERA linking to the claim, where available by payer (may require additional contracting)
• Emdeon payer list quick link within Emdeon Vision
• View all customer communications from payers and/or Emdeon for the last 30 days
• And more!
View the Release Notes and FAQ for more details!
If your providers haven’t signed up for Emdeon Vision, it’s not too late! Emdeon Vision is available at no extra charge as a standard part of our service! Providers can sign up at www.emdeon.com/signup.
Emdeon webinar series
Emdeon offers informative webinars that will keep you in the loop regarding the latest news, views and issues related to reform legislation and your business.
June
Healthcare Policy Reform have you stumped?
Live event June 16, 2010 at 11:00am Central/ 12:00pm Eastern
Ideal for Practice Management and EMR vendors: Programmers, Compliance Officers, CEO, COO, EDI managers, Organizational leaders
July
Reducing support issues while increasing customer satisfaction
Live event July 29, 2010 at 11:00am Central/ 12:00pm Eastern
Ideal for Practice Management and EMR vendors: EDI managers, financial officers, account managers, sales managers
August
Industry hot topics: Meaningful Use, ePrescribing and Electronic Funds Transfer (EFT)
Live event August 17, 2010 at 11:00am Central/ 12:00pm Eastern
Ideal for Practice Management and EMR vendors: CFO, CEO, COO, EDI managers, financial officers, account managers, sales managers
September
HIPAA 5010 solutions that work for you
Live event September 23, 2010 at 11:00am Central/ 12:00pm Eastern
Ideal for Practice Management and EMR vendors: Programmers,compliance officers, CEO, COO, EDI managers, organizational leaders
New payers on board
The Emdeon network of payers continues to grow
New payers added recently:
•Aetna Better Health- PA Medicaid- Claims
•AETNA ENCOUNTERS- Claims
•AFFINITY MEDICAL GROUP- Claims
•American National Ins. Co. (ANICO)- ERA
•American National Property and Casualty Company (ANPAC)- Claims
•Americas 1st Choice Health Plans of North Carolina, Inc.- Claims
•AmeriChoice of New Jersey, Inc. (Medicaid NJ)- Claims
•Auto Club Insurance Association- Claims
•Blue Cross Blue Shield of Kansas City MO- Claims
•Blue Cross Blue Shield of Kansas City MO- ERA
•Blue Cross Blue Shield of Louisiana- ERA
•Blue Cross of Nebraska- ERA
•C&O Employees Hospital Association- Claims
•CAP Management Systems- Claims
•Carolina Crescent Health Plan Inc.- ERA
•Carpenters Health and Welfare Fund of Philadelphia- Claims
•CeltiCare- ERA
•Cenpatico Massachuetts- ERA
•CIGNA ENCOUNTERS- Claims
•Claims Management Services- ERA
•Community Health Electronic Claims/CHEC/webTPA- ERA
•Contractors Laborers Teamsters & Engineers- Claims
•Correctional Medical Services- Claims
•CT Medicare Part A (J13- NGS)- ERA
•Delta Dental of Arizona- ERA
•Delta Dental of Illinois- ERA
•Deseret Mutual- ERA
•DiaTri, LLC- Claims
•District of Columbia Medicaid- ERA
•Edwards Claim Administration- Claims
•FIRST ADMINISTRATORS, INC- Claims
•Great American (GAFRI)- Claims
•Guardian Life Insurance Company of America- ERA
•HARPETH IPA/SRRIPA- Claims
•Health Partners of Minnesota- Commercial- ERA
•Health Partners of Minnesota- Medicaid- ERA
•Health Right- Claims
•Independence Medical Group- Tulare- Claims
•Integral Quality Care- Claims
•InterCare Health Plans Inc.- Claims
•J1 MAC Medicare Part A (CA,HI,NV)- ERA
•Louisiana Medicaid- ERA
•MI Medicare Part A (J8)- ERA
•Mississippi Medicaid- ERA
•MMSI- ERA
•Molina Healthcare of New Mexico- Salud- Claims
•Motion Pictures Industry- Claims
•NC Medicare Part A (J11)- ERA
•Nebraska Medicaid- ERA
•New Hampshire Medicaid- ERA
•New York State Insurance Fund (NYSIF)- Claims
•NJ Medicare Part A (J12- Highmark)- ERA
•North American Benefits Network (Cleveland, OH)- Claims
•North Dakota Medicaid (Hospital)- Claims
•NYS DOH UCP- Claims
•Physicians Care Repricing- Claims
•Premera Blue Cross- ERA
•QuikTrip- ERA
•Sanford Health Plan- ERA
•SCAN ENCOUNTERS- Claims
•SelectHealth- ERA
•Southeast Dental Associates- Claims
•State Farm (Casualty & Property Claims)- Claims
•Sun Life and Health Insurance Company (U.S.) (formerly GLHIC)- ERA
•Touchstone Health PSO- ERA
•Triple-S, Inc.- ERA
•UCARE of Minnesota- ERA
•United Health Plan Encounters- Claims
•Utah Medicaid- Claims
•VI Medicare Part B (J9- First Coast)- ERA
•WEA Insurance Group- Claims
•WPS Tricare TriWest- ERA
For a complete list of the payers in our network, visit our website at www.emdeon.com/payerlists/
