Specialized Product Features

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

SUBROGATION

Automatically detect and manage subrogation situations. Produce letters, track responses and manage reimbursements.

AUTOMATED CLAIM ADJUSTMENTS

There are situations beyond your control that require re-evaluation of claims after they have completed their life cycle. This could be due to a retro - active plan change or even a mistake in your contract or plan configuration causing claims to be computed incorrectly. VISOVA’s automated adjustment tools allow you to correct the situation. Claims are automatically adjusted, creating a reversal of the original transaction and then creating a new adjusted claim with the correct processing.

SPECIAL PAYMENT DIRECTIVES

VISOVA contains the ability to manage special payment arrangements. Specific state based payment penalties based on clean/unclean claim s can be defined to provide interest payments or penalties when you are not able to meet prompt payment guidelines. You can also manage prompt-payment discounts, tax withholding and sequestration activities based on provider specific rules.

HRA/HSA INTEGRATION

VISOVA contains a robust and flexible HRA/ HSA management system allowing you to manage individual balances, healthy activity incentives, and automatically produce payments to providers for patient out of pocket costs associated with a claim.

Davis - Bacon Hour banking

Manage enrollment and coverage using standard Davis - Bacon processing rules associated with reported monthly service hours