Sigmund Software, LLC

ELECTRONIC DATA INTERCHANGE

Sigmund Software’s partner of choice for Electronic Data Interchange Services is Emdeon™ Business Services (formerly WebMD™). Sigmund offers connection to the broadest range of payers and the most sophisticated features. Functions are seamlessly and conveniently integrated into Sigmund’s benefits, authorization, billing and receivables workflows.




Selected Features Summary

Eligibility and Benefit Verification

The Sigmund / Emdeon™ partnership offers powerful advantages by delivering timely eligibility and benefit information to providers from hundreds of government and commercial payers. Our real-time and batch eligibility solutions can greatly simplify the business of healthcare for providers. The solutions deliver information, when needed, for fast, simple verifications during scheduling, registration, admitting or at any time throughout the revenue cycle. The ability is provided to perform:

• Automated eligibility inquiries
• Authorizations / Pre-certifications
• Claim status
• Referrals
• Address verifications

When seamlessly interfaced with your Sigmund Software, the powers of these tools are increased substantially. Real-time or batch requests are initiated manually or automatically through a variety of methods at multiple points during the revenue cycle. All responses are posted directly back into Sigmund to save providers time and effort.

Claims Submission

• End to End Visibility of the Claims Life Cycle

Faster adjudication and shorter billing cycles result in increased cash flow for providers. The Sigmund / Emdeon™ partnership offers broad payer connectivity and helps eliminate time-consuming paper processes so providers can focus their energy on their patients.

• Transaction Services for Virtually All Payers

Centralizing claims management for virtually all payers and automation of paper claims tasks helps providers work more productively. Emdeon™ delivers an exceptional suite of all-payer transaction services that automate many electronic claims, encounters and Electronic Remittance Advice (ERA) tasks.

• Track Claims from Submission to Delivery

End-to-end claim tracking from electronic submission through delivery to each payer is provided. Information received and generated for each claim throughout the submission process is compiled and presented in an easy-to-understand format through specialized Sigmund interfaces. Sigmund allows for the automatic resubmission of corrected claims. Versatile search methods and claim reports displayed in consistent formats eliminate the labor-intensive work of monitoring paper claims for providers.

Electronic Remittance Advice

Emdeon™ connects to hundreds of payers and Sigmund filters all of your ERA transactions into standardized formats. This automation can save providers considerable administrative time. It eliminates the manual receipt and data entry of paper remittances and reduces errors. ERAs can also be used to automatically generate secondary claims for even greater efficiency. The Sigmund / Emdeon™ partnership affords the following benefits:

• Increased number of electronic remittance transactions with minimal implementation effort
• Industry-leading service levels and a commitment to excellence in ERA processing and delivery
• Dramatically improved matching of payment information to claims
• Quicker payment communications from payers than waiting for delivery of the paper Remittance Advice
• Significantly fewer data entry errors due to the elimination of manual posting of payment information
• Lower administrative costs
• Decreased errors in the reimbursement process
• Accelerated and more accurate secondary billing
• Ability to receive ERA files from hundreds of participating payers, ensuring delivery of clean, easily posted remittance files
• Streamlined daily posting routines, enabling providers to conduct daily transactions more easily, efficiently, accurately and less expensively than before
• Timely reconciliation of claims to revenues

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