Benefits of Membership

As an EDPMA organization, our employees are able to participate in committees that provide them contacts and make their jobs easier. Brault is able to reach out to EDPMA members across the nation and gather critical information within hours of new announcements by payers or noticing new payer behavior. Our providers meet similar groups at Solutions Summit and take away best practice. This is the Organization to belong to.

In an ever-changing payor and reimbursement world, EDPMA has been an invaluable resource for our group. From lobbying for balanced billing, to out-of-network payment standards, to bad payor behaviors such as non- emergent diagnosis denials, EDPMA continues to be the preeminent organization in protecting emergency medicine reimbursement.

We joined EDPMA as an organization after several years of considering the potential benefits. After doing so, it became immediately apparent that we should have done so years ago. The education, networking, and participation benefits have economically far exceeded our membership expense. We have been given the opportunity to actually influence policy that protects and benefits EM as a whole and helps secure our position in the marketplace.

EDPMA along with its coalition partners has been successful in defeating out of network (OON) balance billing prohibitions in numerous states. This likely avoided significant reductions in commercial payor revenue in these states. EDPMA also helped lead the development of a solution to the OON conundrum that removes the patient from the reimbursement disputes with health plans and provides fair coverage for emergency services.

Our physician group was able to establish business relationships which returned more than five times our investment in membership.

As a result of EDPMA’s advocacy efforts reversing the Medicaid down coding policy in Kansas, Vituity expects to recover over $130,000. The policy change also avoids future losses that would have occurred if the policy was not rescinded. EDPMA membership is worth several times the amount Vituity has paid in dues.

It is impressive to see EDPMA members banding together to address issues that plague the business of emergency medicine. Members put aside their competitive nature and work cohesively regardless of the size of their organization. Recently, our billing company had an issue with a large national insurance payer over an egregious audit for one of our emergency physician clients. We were able to participate in the calls with the EDPMA State Regulatory and Insurance Committee and found we were not alone with the issue and that many members were facing the same problem with the payer. The members all shared best practices and their appeal results. This information was helpful when lodging complaints with the insurance commissioner in our State. More importantly, we successfully overturned 100% of the audit findings in our appeal! We are one of the newest members to the EDPMA organization; however, it took very little time to become acquainted with other members and benefit from all EDPMA offers. Everyone I met at the Solutions Summit conference was genuinely interested in me and my role within my company. It was easy to develop friendships and networking contacts. As a result, I am able to perform and provide better results for my emergency physician clients and our company.

EDPMA is an extremely nimble and responsive organization.  We utilize significant decision makers in each member organization, and routinely mobilize effective, large scale responses to burning issues and emerging concerns that affect emergency medicine care.