Claims Receivables

Health Benefits Administration Software | Self Insurance Administration Software | Repricing Software | Claims Payment Software | Medicare Pricing Software | Benefit Plan Management software | Capitation Software | EDI software

Some entities that use VISOVA are a middle-man between the provider and the payer either due to capitated arrangements or unique market positions. These entities typically receive claims from providers (or are a provider themselves), and are then billed to a payer via EDI 837, proprietary file, paper HCFA/UB or report. Reimbursement from the payer can be automatically posted if provided in EDI 835 or CSV files, as well as manually against service line level data. As payments are posted, the system can compute service fees/profit and produce payment to provider.