Emdeon Clearinghouse EDI Program Guidelines

Emdeon Clearinghouse EDIEmdeon Clearinghouse EDI program connects providers, payers and other health care partners using computers and communications networks or modems and ordinary phone lines. It allows you to send and receive vital healthcare information electronically. Information is sent from your billing or practice management system to an Emdeon Clearinghouse EDI network where it is verified for accuracy and then sent straight through to the payer’s computer systems.

Emdeon partners with hundreds of practice management system vendors to bring the connectivity to Emdeon Clearinghouse EDI network. As an industry leader with decades of experience, Emdeon provides EDI solutions and connectivity to more than 500,000 providers and 1,200 payers for claim, ERA and real-time eligibility and benefit verification transactions. With Emdeon Clearinghouse EDI, you will benefit through:

• The nation’s largest clearinghouse with the greatest provider reach in the industry
• Multiple transaction types in HIPAA-compliant formats
• Available data verification and edits that reduces rejections
• No additional software to install
• Expert and efficient implementation

Offering dedicated resources and on-going communication and support, Emdeon’s team of highly trained professionals helps business partners experience accurate and timely implementation for claim and ERA transaction capability. As an implementing partner, you will receive:

• A single business contact throughout the implementation process
• Continuous communication & status updates
• Detailed implementation project plans
• Reliable, flexible, secure systems and state-of-the-art technology
• Post-production monitoring.

The Emdeon Implementation department works with two sets of users – new and converting. Before embarking on your implementation process, please review the options with your Emdeon contact.

During the Implementation process, the customer becomes familiar with Emdeon system processes, edits, reports, resources, and enrollment. In addition to a structured implementation process, Emdeon offers access to its services and payers through a variety of communication methods.

Existing trading partners that are introducing a new line of business will need to work with Account Management to complete the necessary documentation for a new transaction type. New trading partners are assigned an Implementation Analyst (IA) once the contract is approved. The IA or Account Representative will be your primary contact throughout the implementation process.

All issues or concerns while in Emdeon Clearinghouse EDI production or self-directed implementation should be logged to ON24/7. For customers following a guided implementation, any concerns should be discussed with your primary contact in Account Management or Implementation before contacting customer or technical support.

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