Provider Portal

Self-Service at your Fingertips

Give your provider network a self-service tool to access critical information like eligibility verificaton, claim status inquires, electronic payment and vouchers, direct claim file upload, and direct claim data entry. Provider Portals reduce your number of support inquiries and allow your team to serve your members better.

Features and Benefits

How Provider Portal Implementation Works

VisibilEDI technical and account management teams will work with you to get you up-and-running and to support you over time.

Data Preparation and Import

VisibilEDI technical staff will provide a file specification for each of the four data types (in X12 5010 or standard flat-file format) listed below and work with your team to get that data imported.

  1. Portal User Registration: Extract of the required vendor/provider data.
  2. Eligibility Verification: Extract of required member eligibility.
  3. Claim Status Inquiry: An X12 837 or extract of required claims.
  4. Provider Payments & Vouchers: An X12 835 or extract of required payment data.

Consulting and Support Services

VisibilEDI account managers will prepare your team to train your provider community on portal usage, cover best practices, and support your team after implementation transitions to steady-state production. VisibilEDI will:

  • Collaborate with your EDI operations and IT staff to ensure a smooth transition.
  • Ensure all appropriate automation and monitoring is production-ready.
  • Tailor the Provider Portal User Guide to support your specific requirements to reduce inquiries.
  • Prepare your provider relations staff with “train-the-trainer” sessions.
  • Attend Provider Portal training sessions with your staff as backup and support.
  • Establish regular recurring meetings with your support staff to discuss issues, improvements, and other topics to better support the provider community.