Emdeon, a provider of healthcare revenue and payment cycle management and clinical information exchange solutions, has acquired EquiClaim, a provider of healthcare audit and recovery services for commercial and government payers, from MultiPlan.
Emdeon paid approximately $41 million in cash for this transaction at closing.
EquiClaim's solutions are designed to provide credible and objective technology-enabled audit and recovery services for healthcare payers to help ensure appropriate payment in a collaborative manner with providers.
Thanks to the acquisition, Emdeon would be able to offer healthcare payers a more comprehensive suite of prospective and retrospective payment integrity solutions.
"Our acquisition of EquiClaim represents another significant step in Emdeon's strategy to offer comprehensive payment integrity solutions to the healthcare marketplace," said George Lazenby, chief executive officer for Emdeon, in a statement.
Lazenby said that EquiClaim's leading capabilities give Emdeon additional tools to help the company’s customers resolve payment issues arising from the increasing complexities of their provider contracts, reimbursement methodologies and claim payment policies.
He said that Emdeon now has the capability to provide end-to-end prospective and retrospective Payment Integrity Solutions, as well as professional consulting services, to help drive efficiencies and improve cash flows.
“While these solutions are valuable and important today, we anticipate the need for these services to increase as complexities in medical billing and coding rise with the pending conversion from ICD-9 to ICD-10," said Lazenby.
"Emdeon's central position in the claim adjudication workflow allows it to focus on preventing errors as early as possible within the claims adjudication process and is highly complementary to EquiClaim's services," said Kurt Anderson, executive vice president and chief operating officer for EquiClaim.
"We help our customers catch errors that have slipped through the cracks without impacting the payment cycle through our post-payment audit and recovery services. When paired with Emdeon's pre-adjudication solutions, payer customers will have access to a robust scope of options to control the waste associated with improper payments," said Anderson.
Earlier in February, Emdeon announced the expansion of its technology solutions to power the exchange of clinical information for healthcare stakeholders industry wide. According to Emdeon, the clinical information exchange services leverage the company's network to deliver real-time patient information at the point of care when it is needed most. The expanded services will provide patient information to authorized healthcare providers to help improve outcomes by identifying gaps in care and creating medical utilization alerts and will assemble a virtual view of patient information.
Anil Sharma is a contributing editor for HealthTechZone. To read more of his articles, please visit his columnist page.Edited by
Jamie Epstein
