EMDEON

Emdeon is the nation’s largest clearinghouse and the only clearinghouse we know of that spans dental, eRx, professional claims, and facility claims.

What They Say About Themselves

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 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.

Emdeon connects 700,000 providers, 5,000 hospitals, 1,200 payers, 60,000 pharmacies, 450 labs and 80,000 dentists processing 7.4 billion transactions each year.

What We Found

Many large businesses use Emdeon and find them satisfactory. But until recently, Emdeon took support calls only from Resellers, making it extremely frustrating (or impossible) to obtain support as a small practice. If you had claims errors and could not reach your reseller, (typically your billing software provider), calling Emdeon was of little to no use.

Recently, we called Emdeon support (the india team answered the line) and we were unable to get even the simplest questions answered as we did not have a customer-number or case-id. We were calling to ask a basic question about their payer-list, without which we could not determine whether a payer was PAR, or Non-PAR. The inquiry resulted in a pointless circle. Opinions regarding their quality of service and support vary wildly to say the least.

Based on our, and other people’s experience, Clearinghouses.org gives Emdeon a rating of 1 star, or Barely Recommended.

On 2014-07-27 17:53:25.835100
by Tim

Agree about poor customer service, although their prices seem ok to me with the new flat rate. The worst part is when a claim is rejected due to an error on emdeon’s part. Getting the claim corrected is pretty much impossible through them and the time it takes makes it not worth it. Easier to just fax a corrected paper claim directly to the insurance company. We finally decided to stop using their service and the final slap in the face was them making us continue paying their subscription fee for 3 months after we cancelled and stopped using them. No reason for that at all other than greed.

On 2014-05-18 03:43:21.906230
by Jessica

Emdeons pricing is very high and not very reliable within the past 8 months. It seems as though their new management in the Tampa location is not sure of the left from the right, clearly lacks issue resolution solving and cannot explain his theories when it comes to the bottom line. I represent an agency and they releasing of seasoned long time employees has tripled, which is a brow raiser, but the high turn over on new employees is due to lack of management or should I say professional people skills on the claims operations side. I would recommend Evolutions or McKesson hands down. Services were less expensive and more accurate. Emdeon gets 1and 1/2 stars.

On 2014-02-03 17:51:18.386780
by Chris P.

I am a consultant and I have had many clients use Emdeon. Our clients have been pleased with their services. They have a nice dashboard which shows claim denial patterns, number of clean claims, etc. Often I find that once the client understands how to fully utilize their clearinghouse services and learn how navigate their software they are much happier with their services.

On 2014-01-15 19:07:10.199890
by Brian Carris

Greetings! I am a customer support manager with Emdeon and would be happy to assist with the issues you are describing. Please send me a message so I can investigate the concern and advise you best on the best fix. Thank you!

Brian Carris, Manager of Operations, (615)932-2811 bcarris@emdeon.com

On 2013-12-12 15:41:46.578120
by Marcos Mendonca

This company has THE WORST client support. If you have to report an issue, you must register to have access their ON 24/7 portal. The problem is, the registration process must be done by leaving a phone message, period. No email option, no talking to a live person. And guess what? They NEVER contact you back. I’ve been leaving messages for 3 WEEKS (multiple times a day lately), and nobody has called me back yet. So if you become their client, forget about client support. You’ll never get it.

On 2013-10-11 22:07:29.249310
by Anonymous

thanks for the information. I will not be doing business with that company

On 2013-10-11 22:05:40.584840
by marketa

what are your fees and do you charge per month and per doctor. How long does it take to set up an account and what are the start up fee

On 2013-09-30 16:28:41.862960
by Active Care

I have had a terrible time with Emdeon. I have worked with this company for approximately 1 1/2 years and every single day has been a struggle. We are a small medical office which would use Emdeon as our means of communicating with insurance companies. We have had terrible struggles every step of the way with no one contact to guide us through filing rejections and software issues. We are finally giving up and very happy to be rid of this company.

8 Comments

  1. Brian

    We have been using Emdeon for about 6 years in our average size chiropractic office. Over all the job gets done. We also enjoy the emdeon office insurance benefits verification portal which allows us to avoid lengthy phone calls to insurance companies. The flat rate of $85 per month for service is certainly reasonable.

    Warning. If you have any issues that need to be addressed you will be put in contact with India. They are very pleasant but it is impossible to have a successful exchange of pertinent details with them. It is a very frustrating experience. I have been on the brink of leaving emdeon many times because of this. If it weren’t for the immense hassle involved in switching clearinghouses I wouldn’t be with them.

    I would advise anybody to avoid Emdeon in favor of a clearinghouse that offers an american support staff.

    • Brian Carris

      Hi Brian,

      We are pleased that you are finding value with our services, especially our industry-leading eligibility verification solution. Depending upon the product or service, Emdeon has client support based in various locations in the U.S. and internationally. We take great steps to assure that all of our resources are fully trained and are held to exceptional standards in day to day performance. That said, if your or any of our customers experience an issue with service, you do have the ability to speak with a U.S. based professional. You simply need to ask.

      Please don’t hesitate to reach out if we may assist in any issue that is not getting the attention it deserves. Emdeon remains committed to providing the level of service you expect to help you meet your business objectives.

      Thanks,
      Brian
      bcarris@emdeon.com

    • Laura B.

      I echo the above comment. We’ve been with Emdeon for 10 years, mostly because it is too complicated to learn a new system. Their customer service is AWFUL. I am currently in a battle of wills with “Austin” in India. I just refuse to go look up information I KNOW they already have! That is their job! If they can’t find a payer ID for Medicare, then I just give up. My ERA suddenly just disappeared on the Emdeon Office website. I called to inquire, and they asked for my providers’ numbers, our Medicare numbers, our Medicaid numbers, all the payer IDs, and remit details (which, hello, I’m calling because I can’t access that information…!). Ugh. The only thing worse than Emdeon’s customer service is having to talk directly to Texas Medicaid.

  2. Jessica Owens

    Good morning Laura et al,

    I am the Supervisor of Operations here at Emdeon and would like to address any concerns/issues that you have had or are having. Please reach out to me directly at: jowens@emdeon.com
    We strive for excellent customer service and it is concerning to me that you feel you are not receiving that. I would like to work with you collaboratively so that we can exceed your expectations and overall satisfaction with our product and service.

    Sincerely,
    Jessica Owens CRCR, MBA

  3. Renee

    Emdeon may have caused my client millions. She is just now discovering how bad they are and how much money she’s lost and is losing. I will give Emdeon one final opportunity to solve the issue with all the past claims that now got paid. It is beyond unacceptable.

    I have work with Trizetto or Gateway and find them more reliable and efficient.

    I will give Emdeon one opportunity to solve all the denials that is probably in the millions. Good thing she hired us when she did.

  4. Ronak Patel

    EMDEON has a whole has been terrible. First off, I understand the transition with EMDEON OFFICE, EMDEON ONE, CAPARIO, etc, but at the end of the day, they are one company. In transitioning to the new EMDEON ONE, I have updated my Software provider and I had to continue to send paper claims through EMDEON OFFICE. in the first two weeks in handling my rejections, i spent 18-19 hours on the phone with their India customer support which each rep would tell me something is different with my claims once they were rejected. If I corrected what they said, they would have me correcting another issue with the same claim. This happened over and over and over again. I have also been overcharged for sending over 1000 claims due to testing and was told i wouldnt be charged. Not sure who to even talk to to get this reversed, but i have reached out to my sales rep for over 2 months now nothing has happened. After transitioning to EMDEON ONE somewhat, I have been getting better customer service (since I wasnt really receiving any). I am still very lost and staying on the phone with EMDEON ONE (ENROLLMENT DEPT, EDI TECHNICAL SUPPORT, ELIGIBILITY SUPPORT) trying to pin point my issues. ERA doesnt seem to have been setup properly when my EDI implementation specialist set up my account. I have called back 3 times already in trying to address this issue with the first guy telling me he has to call an internal team and wouldnt let me speak to them, second logged the issue again and asked for a screen shots. The eligibility support told me the fastest way to check eligibility would be to enter them in one by one. As he was telling me all this, he was getting an attitude with me. When i asked about the batch capability, he said we can have someone enable that for you but didnt ever tell me how to do it, what format to use, etc. Server outages when submitting electronic claims have been frequent. Bottom line, they dont have it together at all and arent really helping. We are running a doctors office, but spend most of our time on the phone with them. Having buyers remorse and am looking into signing a contract. Its funny with the amount of time practices spend in implementing or transitioning to a new clearinghouse, they would never want to switch again due to the time, effort, and money used in doing so which is why I COMPLETELY understand why EMDEON ONE makes you sign a 2 year agreement. IMHO, they have breached their contract by not providing the quality of service they promised, and I will gladly pay to reverse this entire process. Looking into Trizetto now. Good luck to all.

  5. Buck

    My experience echo’s most of the above. We’re an optometry office and file on most everything medical through Emdeon. The only “luck” we have had lately was to call the buying group we purchase the Emdeon service through and have them light a large blaze under their tails. And this took repeated phone calls by the buying group! They simply don’t have any functional customer service and only responded to us b/c they were endangering thousands of contracts through this buying group. We are going to go with either APEX or Gateway after I make some intense support calls and hope for the best.

  6. Allen

    I have been on the phone with Emdeon for 40 minutes speaking to someone in India that every 3 minutes asks if she can put me on hold for 2-3 minutes. Every time she asks I say “No,” and she says thank you and places me on hold anyway. Nobody there seems to grasp what the issue is that I am having, all I get is “You are receiving your confirmation report in that format because you changed your billing format.” I just enacted ANSI and all the sudden I can’t be told if claims are rejected or not?? I have asked for a supervisor 4 times and she keeps saying, “Let me check with my supervisor, we are getting a lot of calls or I could assist you better.” I just apologized for my attitude because I realize it’s the company she works for’s fault and not her own and to please let me speak with her supervisor so he/she can listen to me instead of her. I am so thankful we are in the process of switching to TriZetto, who’s customer service is solely based in PA.

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