Emdeon Steps In to Address CMS Outages

An Update on Proactive Leadership to Find Resolution for The Centers for Medicare & Medicaid Services (CMS) Medicare Part A & B Processing Issues

Emdeon CEO George Lazenby certainly does not make it a habit to call meetings with Centers for Medicare & Medicaid Services (CMS). Suffice to say, he would only be motivated to do so by the need to address extreme circumstances that greatly affect his clients and the provider community as a whole.

Lazenby recently journeyed to CMS headquarters to sit directly across the table from key leaders at CMS to heighten the resolution of alleviating recent Medicare Part A & B processing issues being experienced industry-wide during eligibility and benefits verification. Emdeon recognizes that the frequent downtime for Medicare A & B eligibility and benefits verification processing costs provider staff valuable time and productivity. As a leader in Simplifying the Business of Healthcare, Emdeon is compelled to actively address these issues and offer aid to CMS in achieving resolution.

Many likely received email updates about Lazenby’s meeting and subsequent responses. Here’s a quick recap of the events to date:

October 14: Lazenby traveled to CMS headquarters to meet with CMS officials and was informed of CMS’s plans to install a new application later in the month that would improve speed and reliability of transaction processing. To demonstrate both scope and breadth of processing issues, Emdeon invited other major eligibility and benefits verification vendors to attend this meeting and share their common concerns. Lazenby offered Emdeon’s IT and network resources to supplement CMS’s efforts.

October 23: CMS installed the Q3 release of the HETS 270/271 application. After post-release testing, CMS opted to revert to the previous version of the application and providers continued to report processing issues. Emdeon accepted CMS’s request for assistance in load testing the new application prior to reinstallation attempts. Emdeon conveyed CMS’s directive to providers to shift all non-immediate response eligibility and benefits verifications to off-peak hours (peak hours defined as Mondays and Tuesdays between 9 a.m. and 4 p.m. Eastern time) to optimize system performance.

November 10: CMS made significant changes to their HETS 270/271 application and conducted overnight testing of their revised application on November 8 through November 12. CMS Technical Staff is working around the clock to prepare for full release. Emdeon continues to remain engaged with CMS during this time and will publish the planned release date as soon as possible following successful testing. A follow-up meeting is in process of being scheduled by Lazenby with CMS to continue to highlight the Medicare Part A & B processing issues and the need for continuous attention until resolution is achieved for the provider community. This meeting should be held in Q4.

Of course, Emdeon will keep you posted regarding this important issue through resolution. Stay tuned for more update emails and information in the Spring edition of the Emdeon Compass.

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