Product Overview

Managing your revenue cycle can be complicated and ever changing.  Healthcare providers and administrators regularly trade time, money and peace of mind to deal with rapidly expanding payer rules, federal regulations and mountains of paper work.
Our world-class clearinghouse provides superior revenue cycle management and revenue enhancement services with outstanding support.

EMEDIX Reimbursement Solutions establishes long-term relationships with our customers by providing an enhanced menu of services to help you send all claim types in various formats, optimizing your cash flow and eliminate missing payments.

Connect to our clearinghouse in one of three ways:
EMEDIX Online (Web-based EDI Solution)
EMEDIX RCM (Desk-top EDI Solution)
EMEDIX Software Integration (Practice Management Integrated EDI Solution)

Features

EMEDIX Online
(Read more)

EMEDIX RCM
(Read more)

EMEDIX Software Integration
(Read more)

Eligibility
(ANSI 270/271)

Real-time eligibility available as single transaction.

Response is returned in human readable form.

Full payer information is returned.

Response can be printed to paper and/or saved to computer.

Pre-check eligibility available before claim is sent to payers.

On-demand eligibility is available from the claim with no data entry. 

Response is returned in human readable form and linked to the claim.

Response is viewable within the claim at any time.

Both Real-time and batch submission are available within the practice management software.

Eligibility Request can be conducted inside a practice management software program, and can be automated.

Eligibility response is returned as an ANSI 271 transaction, and can be imported inside software (eliminate manual typing and opening multiple applications).

Claims
(ANSI 837)

Professional (P)
Institutional (I)
Dental (D)

Professional, Institutional and Dental claims are supported.

ANSI 837 (4010 or 5010) format supported.

One account number for all claim types.

Use Response Manager to view claim errors.

Standard technical and clinical edits are applied to each claim.

Submitted claim files are retained indefinitely.

Professional and Institutional claims are supported.

ANSI (4010 and 510) supported, also compatible with print image format and manual claim entry.

Claim errors are highlighted in red.  Each claim can be corrected ‘on the fly’, rescrubbed, and transmitted to the payer after correction.  Included is a change log of all adjustments.  Claims can also be corrected in bulk.

Standard technical and clinical edits are applied to each claim.  Customized edits and formats are available upon request.

Utilize as a web portal that is compatible with 3rd party practice management systems.

Submitted claim files are retained indefinitely.

Charged only for payer accepted claims.

Professional, Institutional and Dental claims are supported.

ANSI (4010 and 5010) format supported.

Claims can be sent from the practice management software without leaving the program.  Billing process can be automated.

Standard technical and clinical edits are applied to each claim.  Errors can be imported back into the billing program for correction and resubmitted.

All clearinghouse and payer report responses can be incorporated into the software automatically.

Eliminate opening multiple applications.

Submitted claim files are retained indefinitely.

Reporting and
Analytics

Use Response Manager to easily view and manage your rejects online.  

Search for claims or ‘work’ your rejects online.

Paper reports are also available for view and downloading

Payer responses are returned to the individual claim eliminating the need to work from a paper report. 

Status of claim is identified in application along with payer message for resolving rejects.

Report Gateway includes the ability to create customized reports, as well as run and schedule standardized reports.  Receive email alert when report run is completed.

Paper and electronic reports are returned via web service and can be imported into a billing software program.

Response Manager reporting is also available.

Worker’s Compensation

Not PKW segment supported

Supported in ANSI (4010 and 5010) format.

Supported in ANSI (4010 and 5010) format.

Claims Status
(ANSI 276/277)

Real-time claim status inquiry is available as single transaction.

Response is returned in human readable form.

Full payer information is returned.

Response can be printed to paper and/or saved to computer.

Auto-claim status inquiries can be setup to send inquiry to payer under certain conditions (parameters set by user).

On-demand claim status inquiry is available from the claim with no data entry. 

Response is returned in human readable form and linked to the claim.

Full payer information is returned.

Both real-time and batch submission are available from practice management software.

Claim status request (ANSI 276) can be conducted inside a practice management software program, and can be automated.

Claim status response is returned as an ANSI 276 transaction, and can be imported inside software (eliminate manual typing and opening multiple applications).

Full payer information is returned.

Electronic Remittance Advice-ERA
(ANSI 835)

*Ask us about EOB to ERA for an Electronic Version of Your Paper Remittance

835 files may be retrieved and downloaded.

Remit Manager is loaded with all 835 files and makes them available for searching and downloading as both 835 and as a standardized EOB.

Files are retained indefinitely; users can access and download multiple times.

835 files may be retrieved and downloaded.

Standardized EOB (human readable) is linked and viewable from the claim.

Remit Manager is loaded with all 835 files and makes them available for searching and downloading as both 835 and as a standardized EOB.

Files are retained indefinitely; users can access and download multiple times.

The ERA file (ANSI 835) is returned via web service, and can be imported into the practice management software system for auto-posting.

Remit Manager is loaded with all ANSI 835 files and makes them available for searching and downloading as both an 835 and as a standardized EOB.

Files are retained indefinitely; users can access and download multiple times.

Electronic Patient Statements

Statements and collection letters are uploaded in EMEDIX Online. 

Customize colors, add logo, or send inserts. 

View reports on address changes and forwarding available online.

 

Available with EMEDIX Online.

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Available with EMEDIX Online.

 

Support 4010 and 5010

ANSI 4010 files are supported for translating to/from 5010.

Fields are added/removed to comply with rules and validation.

Claims can be converted up or down within the application. 

All claims are scrubbed through the corresponding edits only.

 

ANSI 4010 files are supported for translating to/from 5010.

Fields are added/removed to comply with rules and validation.