There’s much mention of percentages in today’s headlines: “the 1%,” “the 99%” and so on. For those of us in the healthcare industry, let’s hope we’re part of “the 43%.”
According to the U.S. Healthcare Efficiency Index© (USHEI), business efficiency in healthcare stands at 43% based on the most recently collected data. That means 57% of the industry has not transitioned from a paper-based system to an electronic one leaving nearly $30 billion in annual savings unrealized. If you’re part of the 43%, you’re on the leading edge of technology and smart solutions, managing your organization’s business with simplified, standard-setting efficiency that’s not reliant on costly paper processes.
Since 2009, USHEI has been shining a spotlight on the need for greater efficiencies for the business of healthcare. Established under the purview of Emdeon, USHEI is a national, non-affiliated, industry wide measuring tool guided by a team of respected advisors from relevant disciplines. The Index calculates data on electronic-versus-paper transactions for claims, eligibility, payments and remittance to determine percentage of electronic transactions and potential annual savings. Additionally, environmental impact is assessed. USHEI Phase 1 findings revealed the aforementioned 43% efficiencies and pointed to areas for future improvement.
It was recently announced that ownership of the Index is transferring from Emdeon to the Council for Affordable Quality Healthcare (CAQH), heralding the initial steps of Phase 2 for this increasingly important industry reference. As Emdeon’s Senior VP of Clinical Services, Miriam Paramore stated, the CAQH is a “perfect strategic home for the USHEI” for the long term. CAQH plans to add aggregated outcomes data from other CAQH sponsored initiatives, including the Committee on Operating Rules for Information Exchange (CORE), to offer a more comprehensive analysis of the progress.
What does this all mean to you?
As provider organizations like yours face new transaction standards and operating rules contained in the healthcare reform law, you can turn to USHEI for helpful information, inspiration and affirmation. Track USHEI regularly for:
- insights into simplification solutions that are proven effective based on quantifiable results
- supporting data to guide your staff and patients’ comfort levels and acceptance of the electronic transition
- useful stats regarding industry-wide savings that can be used in context to support your organization-specific data
- compelling information regarding the environmental impact of paper-based transactions and the green benefits of going electronic
- ongoing awareness of key issues in the business of healthcare
- a reliable measuring stick to gauge your organization’s progress
- source material for your own internal communications and external Public Relations as you introduce more sweeping electronic solutions for your organization
Learn more about USHEI online at ushealthcareindex.com. There you’ll find details on Phase 1 findings, the USHEI advisory committee and more. Keep visiting the site in the days ahead to be part of the taking “the 43%” to 100% efficiency.
Are You the 43%?
HIPAA Simplified Update (Institutional)
Emdeon continues to guide our customers successfully through the migration to the X12 5010 and NCPDP D.0 versions of the HIPAA transaction standards. We have enhanced our 5010 systems and solutions to support the Errata versions of HIPAA transactions. The Errata versions of the gap analysis documents are available at the HIPAA Simplified website under the ‘Downloads’ section.
We strive to provide you with the most updated and accurate information regarding our readiness for HIPAA 5010. Please see below for answers to the most commonly asked questions regarding HIPAA 5010.
What is Emdeon’s current state and plans for HIPAA 5010 testing?
Emdeon is currently testing and implementing 5010 with submitters and payers while already in production with some payers and submitters. The late release of the Errata changes to the 5010 transaction standards further constricted the already narrow 5010 testing and conversion window. Nevertheless, as you can see in the list below, Emdeon has initiated submitter and payer testing on all 5010 transactions.
Errata testing/production in process:
• 837 Professional claims
• 837 Institutional claims
• 837 Dental claims
• 835 ERAs
• 270/271 Eligibility verification
Emdeon is also testing and implementing the Final Rule version with submitters and payers for the HIPAA X12 transactions that were not included in the Errata revisions:
• 276/277 Claim Status
• 278 Referral/Authorization
What Emdeon solutions are impacted by 5010?
5010 impacts eligibility, claim, claim status and remittance transactions. The associated Emdeon solutions impacted by 5010 include our clearinghouse, as well as:
• Emdeon Assistant
• Emdeon Receivables Analytics (RA)
• Emdeon Claim Master®
• Emdeon Payment Manager
• Emdeon AccuPost
Please select links above to view the HIPAA 5010 factsheets for these products.
Note: HBS and Legacy Claim Master products are NOT being modified to be 5010 compliant. Clients on these products are already being migrated to the latest release of Emdeon Claim Master to meet 5010 requirements. These migrations are targeted to be completed by December 31, 2011*
How will my organization be notified of any product updates if required?
Emdeon has created a global communications plan for our clients. In addition, HIPAA 5010 Product fact sheets are available and being distributed for each product line. Remember to frequently visit Emdeon’s hipaasimplified.com website which has been recently updated and reorganized to contain new valuable content like product fact sheets and product specific testing information.
What is the timeline(s) of events?
The compliance date of HIPAA 5010 conversion is January 1st, 2012*. All Emdeon products and services have been remediated for 5010; we are in testing phase with many submitters and payers while already in production with some submitters and payers.
Is 5010 delayed until March 2012?
No, the compliance date for 5010 standards remains January 1, 2012, however on November 17th , 2011, CMS announced that the Office of E-Health Standards and Services (OESS) would not initiate enforcement action until March 31, 2012. Emdeon strongly encourages its clients to meet the January 1 compliance deadline if possible. Customers should not view this announcement as a 90 day extension of the compliance date and should continue testing earnestly with their trading partners to meet the end of the year deadline. http://www.cms.gov/ICD10/Downloads/CMSStatement5010EnforcementDiscretion111711.pdf
Did Emdeon participate in the CMS National version 5010 Testing Days?
Yes, Emdeon did participate in the CMS National version 5010 testing day on June 14th and also in the subsequent testing week (August 22nd to August 26th). Emdeon sent test files to all Medicare Administrative Contractors (MACs) during both these testing periods.
Where can I obtain additional information about HIPAA 5010?
Emdeon created a valuable web resource available to all industry stakeholders titled HIPAA Simplified, which may be found at hipaasimplified.com. HIPAA Simplified is a one-stop online resource that features gap analysis, business level documentation, webinars, timelines for the transition and testing information for our customers.
Thank you for trusting Emdeon as your source for HIPAA readiness. We work diligently to deliver solutions that enable our customers to seamlessly meet these industry regulatory requirements.
*The compliance date for 5010 standards remains January 1, 2012, however on November 17th, 2011, CMS announced that the Office of E-Health Standards and Services (OESS) would not initiate enforcement action until March 31, 2012. Emdeon strongly encourages its clients to meet the January 1, 2012 compliance deadline if possible.
What’s the Big Deal About Emdeon Payment Automation?
Would you consider the capability to get paid faster and more completely while also reducing manual processes and the need for full-time staff to be a big deal? Of course you would. The evolving healthcare landscape demands that providers of all sizes find solutions to not only collect more revenue, but be more efficient in doing so. Any alternative that results in greater reimbursement and staff efficiencies is, simply put, a big deal.
That’s where Emdeon Payment Automation comes in. Providers nationwide are reaping the revenue from automated solutions for processing paper Remittance Advice (RA) and Explanation of Benefits (EOBs) for one streamlined workflow. We’re empowering providers to eliminate burdensome, manual processes related to paper with automation to post commercial insurance payments promptly and accurately.
Rather than just tell you of Emdeon Payment Automation’s powerful impact from our vantage point, we’d prefer to show you its benefits through a recently-released case study featuring a prominent medium-sized organization’s surprisingly simple and quick journey to big time benefits.
Download this compelling case-in-point to discover:
- the shortcomings of a bank’s EOB processing system and lockbox services
- how long it took and how many people were needed to post payments and correct Electronic Remittance Advice (ERA) errors for this provider organization
- the many, measurable ways Emdeon Payment Automation improved the situation
- an executive’s firsthand account of Emdeon’s implementation process and support
- how long it took for the provider organization to break even on its investment in Emdeon’s solution
While this Emdeon Customer Success Story is a relevant read for any organization seeking a practical, simple-to-implement payment automation solution, it’s particularly fitting for providers that are:
- still using an inordinately large dedicated staff to handle manual commercial payer payment processes
- currently tied to a bank for payment process and lockbox support
- struggling with posting errors and subsequent revisiting of items posted
- in need of higher first-pass yield, reduction of denials and all-around better data accuracy
- looking for a simple-to-integrate, automated solution that will enhance efficiencies and bring big deal results
With Emdeon, achieving those big deal results can be a relatively small feat. We cover all the details to get you up and running with automated payment solutions promptly and offer integration to make workflows as seamless as possible.
Click here to download the case study and learn more!
Customer Support Around the Clock
Access Emdeon’s web-based, secure support system 24 hours a day, seven days a week! Emdeon ON24/7 enables you to easily submit service requests for most Emdeon Revenue Cycle Management Solutions whenever you need. Helping you stay up-to-date on the current status of any request, ON24/7 sends confirmation emails when requests are received and ongoing progress reports. In addition, you can rest assured that your service requests are being handled by Emdeon’s team of experienced professionals who know your systems.
Enroll Today! Call 800.819.7965 and select Option 1 today to enroll in ON24/7 and start accessing support and communication tools via the Internet 24 hours a day, seven days a week.
Emdeon Adds New Payer Transactions
The largest healthcare revenue and payment cycle network continues to grow!
Emdeon connects you and 340,000 other providers to 1,200 payers, the nation’s largest healthcare revenue and payment cycle network. We’re constantly adding new payers and new transactions to this network, giving you even greater reach for real-time eligibility and benefits verification and electronic claims submission. View our complete payer list to make sure you’re taking advantage of Emdeon’s connectivity for all available transactions today. The more payer connections you access through our network, the quicker you can begin receiving accurate reimbursements, reducing write-offs and improving first pass acceptance rates.
We’ve recently added the following payer transactions:
• AmeriChoice of New Jersey, Inc. (Medicaid NJ) - Claims
• Bay Area Automotive Group - Claims
• Benefit Management Administrators - Claims
• Bridgestone/Firestone - ERA
• CA Home Health & Hospice - Claims
• Cardiovascular Care Providers - Claims
• CBHNP – HealthChoices - Claims
• Christian Brothers Services - Claims
• Crescent PPO, Inc.- Claims
• Delaware Physicians Care, Inc. - ERA
• Dental Management Administrators - ERA
• Fidelio Dental Insurance Company - Claims
• Florida Hospital Waterman - ERA
• Global Excel Management - Claims
• Good Shepherd Hospice Inc. - Claims
• Harrington Health Non-EPO - Claims
• HealthEdge Administrators - Claims
• InterCare Health Plans Inc. - Claims
• Life Pittsburgh - Claims
• LifePath Hospice Inc. - Claims
• MHNET - ERA
• MMSI - ERA
• Mutual Assurance Administrators - Claims
• New Avenues, Inc. - Claims
• Ohio PPO Connect - Claims
• PacificSource Medicare - Claims
• Partners Benefit Group - Claims
• Sendero Health - Claims
Don’t miss out! View our complete payer list online today. Put in your Emdeon ON24/7 request to map to any new payers or transactions available to take advantage of Emdeon’s connectivity!
Complimentary Case Study Download: Baptist Health Systems Sees the Pay-off of Online Patient Payment Solutions
Offering patients the ability to pay online aids in collecting revenue more promptly and fully, with less drain on staff time and resources. When Baptist Health Systems (BHS) in Jackson, Mississippi implemented Emdeon Patient Pay Online in March 2010, the organization was in a revenue optimization mode, making the efficiencies associated with implementing an online payment collection portal incredibly appealing and necessary.
More than a year after launch, Angie Buckley, Director of Business Services, reports that the system has performed as anticipated in aiding collections. In addition to helping BHS reduce costs by automating the collection of patient payments, the most positive result for BHS has been the empowerment and satisfaction of patients.
Download this complimentary Emdeon customer success story and Listen Now at no charge to a recent Emdeon podcast “Online Patient Billing: Provider and Patient Benefits” to hear more online patient payment solutions and tips.
