Emdeon Inc., a provider of healthcare revenue and payment cycle management and clinical information exchange solutions, today announced plans to present short, impactful educational sessions relating to its recently launched Emdeon EDGE(TM) payment integrity solution suite at Emdeon's in-booth theater (booth 101) during the National Health Care Anti-Fraud Association (NHCAA) conference, which will be held in Anaheim, California from November 13-16, 2012. The presentations will examine the evolution of fraud, waste and abuse protection from a solely "pay-and-chase" model to a comprehensive pre-pay through post-pay solution.
Emdeon also will highlight how Emdeon EDGE leverages multi-payer data and analytics to effectively fight against healthcare fraud, waste and abuse.
Healthcare fraud, waste and abuse in the United States continues to be an increasing problem with industry estimates placing the cost upwards of $200 billion a year. In fact, a joint letter from the secretary of Health and Human Services and the U.S. attorney general issued in September 2012 emphasized to healthcare trade organizations the need to ensure accurate and proper healthcare claims, and stated that attempts to "game the system" will not be tolerated.
Emdeon has built a leading payment integrity and cost containment solution by acquiring three market leaders - The Sentinel Group, EquiClaim and TC3 Health - and integrating them with Emdeon's vast healthcare network. By combining the best of these companies' recognized leadership in fraud, waste and abuse technology, investigation expertise, cost management services and comprehensive audit and recovery services, Emdeon is able to offer healthcare payers one complete solution to help ensure accurate claim payments throughout the adjudication lifecycle.
"In a time where healthcare payers are under immense pressure to control costs, Emdeon's payment integrity solutions can offer the healthcare payer community immediate benefits with minimal investment," said Terry Cameron, senior vice president of payment integrity for Emdeon. "Emdeon EDGE combines analytics from its multi-payer data with knowledge and expertise to create more efficient payment integrity processes and more savings opportunities." Emdeon will exhibit Emdeon EDGE and present educational sessions at booth 101 at the NHCAA conference.
Gaining an Edge on More than Just "Fraudsters"Tuesday, November 13th, 6 pm PTThursday, November 15th, 12:45 pm PTPresented by Kelli Garvanian, Payment Integrity Solutions Consultant, Emdeon The term "Payment Integrity" has many definitions within healthcare, mostly associated with fraud. But it addresses much more than just fraud - payment integrity includes identifying incorrect coding, payment errors, misrouted claims and really just about any improper payment. Learn how to gain an edge by applying industry best practices to achieve a holistic, highly-effective payment integrity approach.
Unbelievable Tales of Fraud You've Thwarted - And What We Can Learn From ThemWednesday, November 14th, 6 pm PTPresented by Kelli Garvanian, Payment Integrity Solutions Consultant, Emdeon We all have them - stories that confirm fact can be stranger than fiction. Join industry thought leader Kelli Garvanian as she retells some of the craziest tales Emdeon has helped expose - and what you can learn from them. Then, we'll hand the microphone over to the audience and let you share your wildest stories and how they made you and your company better. Face it, a benefit of our industry is getting to share the stuff you just can't make up, so don't miss this session. We're sure this one is going to become an annual favorite! In addition, be sure to check out the following NHCAA concurrent workshop sessions on Thursday, November 15th that will be presented by Emdeon: The Payment Integrity Paradigm Shift: Ensuring the Financial Health of your Organization7:00 am PTPresented by Jean Lyon, RN, MS - Vice President - Payment Integrity, Emdeon How does a pre-payment versus post-payment fraud, waste and abuse prevention program measure up? What are the benefits and risks of both methods? Learn the components of a successful pre-payment investigation, along with a number of case studies that illustrate the advantages of the pre-payment approach.
Building Smart Analytics to Eliminate False Positives in Fraud Detection10:45 am PT Presented by: Kelli Garvanian - Payment Integrity Solutions Consultant, Emdeon Bart Masters - Payment Integrity Analytics Statistician, Emdeon False positives drain your resources. With advances in technology and data access, you can lessen their impact. Learn how using smarter analytics can help keep you focused on the cases that really are real.
Emdeon is a 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.