Problems with Emdeon?

hjoesaar · Post by **hjoesaar** » Wed Jan 16, 2008 8:16 am

We're in a money bind right now because we're not receiving insurance reimbursements as we should. I finally looked into it and a substantial amount of our Eclaim from November/December had to be re-sent lately. When I say substantial I'm talking about 15 or so (that we know about). They were from a variety of insurance companies - it seems that they never got them in the first place! Our Eclaim reports show that they were sent but the insurance companies didn't receive them. Before I call Emdeon, has anyone else had this problem? Thanks! - Harald

Post by **jordansparks** » Wed Jan 16, 2008 11:08 am

I think there is a significant disconnect right now between the insurance companies and the dental offices. The status checking situation should improve over the next few years as OD and the insurance companies get more tightly integrated. Specifically, you will be able to do a status check on any claim to actually check whether the insurance company got the claim. The result of the status check will come straight back from the insurance company, not from the clearinghouse.

Until then... well, we'll have occasional situations like this, where nobody really knows who dropped the ball, and it takes time to even notice that it happened. But if your report from Emdeon says Emdeon received it, then it seems like it's Emdeon's responsibility to tell you why the insurance company didn't get the claim.