Next-Generation Clearinghouse

Reduce cost and boost performance with our next-gen clearinghouse capabilities. Increase cash-flow and first-pass payment rates by utilizing our integrated transaction portal to check eligibility, submit referrals/authorizations and claims, and receive payment. Support workflows that maximize revenue with tools that allow you to efficiently manage your exchanges with health plans and other trading partners with less effort.

Primary Drivers

  • Reduce administrative costs by more than 25% with our transaction support tools
  • Support higher levels of automated claims and payment processing
  • Increase first-pass payment rates with targeted business rules
  • Streamline workflow and processing to maximize revenue
  • Visualize data flows via an online transaction repository with dashboard reporting
  • Streamline effort to manage EDI processing, operations and support
  • Reduce the cost for HIPAA compliance while staying current with regulatory changes
  • Exceptional flexibility and support for all file types and formats

Next Generation Clearinghouse Capabilities

  • Fully cloud-based EDI processing services for real-time collaboration, streamlining administration for health plans and providers
  • Full visualization of workflow enable business analysts to easily manage, remediate and report on incomplete and rejected transactions
  • Intuitive admin console providing transparency into EDI transactions as well as simplified reporting interfaces for all your business partners and customers
  • Automated data processing allowing healthcare transactions to be funneled through a robust translation and rules engine to route, validate, fill, audit, reject/drop, integrate, and report individual or batch level transactions
  • Much more productive than easierthan classic monolithic clearinghouse models. VisibilEDI delivers excellent customer support coupled with superior EDI workflow processing for payers and providers enabling a higher degree of success for less effort
  • Business Rules Engine incorporating 15 years of business transaction processing expertise with over 1500 pre-configured business rules enabling exceptional file optimization, processing capabilities, and exception logging and reporting
  • Easily import and convert any proprietary file into EDI X12 HIPAA compliant transaction
  • Simplified implementation enabling client success in the shortest amount of time possible.
  • Fully configured to support trading partners and outsourced business processes (i.e. claims re-pricing and claim scanning)
  • Reduce cost and need for in-house development and application support for EDI processing