Provider Management VISOVA’S provider system is designed to provide you with the level of control you need for your business. Organizations that require the most control, typically use the extensive credentialing features to create an approval path for the provider to be made available as a contracted provider. Other organizations may receive rosters for provider affiliation that can be loaded into the system using its trading partner based provider import tools. The provider system does not have to be pre-populated to process claims, as provider data can be extracted from claims while being processed, and added to your provider repository automatically.
DEMOGRAPHICS
- Unlimited provider addresses
- Track by User Defined Id’s, NPI, UPIN, TAX ID, etc.
- Manage Provider Groups
- Provider Locator functions
- Manage Hospitals, Physicians, Labs, and all ancillary provider types
CREDENTIALING
VISOVA’s credentialing dashboard consolidates all provider related credentialing data for global view and rapid navigation to the details. Tickler tracking based controls help you be proactive and keep providers on track and help you toward your goals of URAC standards.
PROVIDER ESSENTIALS
- Multiple Addresses
- PPO Contracts per address
- Board Certifications
- Education
- Hospital privileges
- Insurance coverage
- Licenses
- Custom user controls
- Letter Generation
- Tools to copy, move, merge, and mass change
INBOUND/OUTBOUND PROVIDER DATA
- Accept provider data using same scrubbing and duplicate prevention rules used throughout
- Automatically create provider outbound rosters by client/payer
NETWORK CONTRACT CONTROLS
- Associate a single provider address/tax id to an unlimited number of network contracts
- Identify PCP participation, availability and population rates.
- PCP coverage rules
- Referral Controls
- Automated, intelligent denials and holds
- Leased network affiliations
- Ranking
- Directory inclusion
- Alternate Id’s