Emdeon data and analytics capabilities utilized to help identify eligible providers for reimbursement
NASHVILLE, Tenn., Feb. 21, 2012 /PRNewswire/ -- Emdeon Inc., a leading provider of revenue and payment cycle management and clinical information exchange solutions, today announced its ongoing efforts to facilitate the distribution of more than $25 million of reimbursement funds owed to over 75,000 physicians, as a result of the 2009 settlement of a class action lawsuit involving out-of-network reimbursement policies.
The American Medical Association (AMA) and a number of state medical societies filed a class action lawsuit in 2008, alleging certain health insurance claims had been underpaid for out-of-network services. The lawsuit was settled for $350 million—and, on February 3, 2012, a federal court judge issued rulings to release nearly $200 million for claims that physicians had filed.
Shortly after the lawsuit was settled, Emdeon began working with the Managed Care Advisory Group (MCAG), who was selected to enroll and subsequently facilitate payments to impacted providers. As the single largest financial and administrative health information network in the nation, Emdeon was able to utilize its data assets and analytics capabilities to work together with MCAG and communicate with physician groups regarding reimbursements to which they are entitled. Emdeon and MCAG also assisted in processing physicians' proof of claims, effectively reducing the administrative burden typically associated with class action claims.
"We are very pleased that we could utilize our data and analytics capabilities in conjunction with the efforts of MCAG to help our provider customers participate in this settlement," said Philip Hardin, executive vice president of Provider Services for Emdeon. "Our solutions help simplify the complex business of healthcare, and in this case, we succeeded in assisting our providers' navigation through a complex process and receive reimbursement."
With the settlement funds now being released by the court, Emdeon will continue to work with MCAG to facilitate payments directly to physicians and their technology partners.
"Class action lawsuits can be complex, confusing and time consuming," said Tim Schmidt, president of MCAG. "Without Emdeon's market intelligence and technological expertise, it is unlikely we could have helped providers receive their payments in such a timely and efficient manner."
To learn more about the lawsuit and settlement, visit the AMA website.
Emdeon is a leading 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 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 and clinical information exchange processes. For more information, visit www.emdeon.com.
SOURCE Emdeon Inc.