Net Select

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

VISOVA allows you to configure logically ranked Client Products, Member Enrollment and Provider Pricing rules that will allow you to automatically control the life cycle of a claim. This process is performed every time a claim is analyzed for its next step in its life-cycle. We call this important process: "Net Select"

Net Select helps determine the rules that may apply to the claim:

  • Duplicate detection methods
  • Enrollment determination
  • Pre-Certification and Referral restrictions
  • PCP Involvement
  • COB Rules
  • Process method (PPO Re-pricing, Adjudicate Only, Re-Price and Adjudicate, Billing only, Access only)
  • Rate and Payment controls
  • Output determination
  • Ranking and routing
  • Out of Network handling
  • Messaging
  • User defined rules
  • Filters
  • Etc.,