VisibilEDI

SOLUTIONS

Real-Time EDI Transactions

Eligibility | Referrals & Authorization | Claim Status

Reduce cost and improve performance by incorporating real-time transactions in your EDI workflow and processing. Decrease administrative cost and resources used to make phone calls to verify coverage and initiate referrals. Streamline operational investment through use of automation to improve quality of care.

Primary Drivers

Eligibility (270/271)
  • Minimize the need for phone calls to individual health plans
  • Reduce operational cost to verify coverage
  • Increase productivity and efficiency
  • Reduce rejected claims; collection/billing costs and bad debt
  • Leverage CORE/CAQH compliant health plan services
  • Lower write-offs and turnaround time from payers
Referrals & Authorization (278)
  • Improve authorization accuracy and timeliness
  • Reduce administrative resources spent with referrals and authorizations
  • Minimize the need for phone calls and individual inquiries
  • Increase productivity and efficiency
  • Lower write-offs and turnaround time from payers requirements.
  • Decrease errors due to poor technology and communication
Claim Status & Inquiry (276/277)
  • Reduce operational cost for tracking down claim status
  • Minimize the need for phone calls and individual inquiries
  • Decrease duplicate claim submissions
  • Leverage CORE/CAQH compliant health plan services
  • Increase productivity and efficiency
  • Lower operational cost and improve efficiency
Real-Time Transaction Capabilities
  • Full cloud-enabled EDI processing bringing simplified EDI administration for health plans and providers.
  • Intuitive and visual interface enabling business analysts and administrative personnel to easily manage, remediate, and report on incomplete and rejected transactions
  • Visualize data flows via an online transaction repository with dashboard reporting
  • Clear administration capabilities providing visualization of all EDI transactions as well as remediation, tracking, and reporting for trading partners and connections
  • Automated EDI data processing through a robust business rules engine to validate, audit, reject, and report on all transactions
  • Significantly more efficient and much less expensive than onsite configured EDI solutions
  • Business Rules Engine incorporating 15+ years of EDI transaction processing expertise configured with file optimization, business rules, and exception logging and reporting
  • Configured to support file import and conversion of proprietary file format into standard EDI X12 HIPAA compliant transactions
  • Eliminates need for in-house development and application support by healthcare EDI professionals responsible for managing proprietary transactions with trading partners