Monthly Archives: April 2014

VBA Software February 2014 Release Notes – Including The ALL NEW VBAGateway Web Portal

February Release Notes AUTH SERVICES
  • Claims requiring Auths will now have to match the modifiers for any procedure code on the claim. Four Modifier fields have been added to the Procedure Code section of the Auth update screen to allow for the input of these modifiers (Image 1).
  • The field size of Referred By Name has been increased from 50 characters to 512 characters. This prevents a truncation error when a user looks up a Provider with an Org Name greater than 50 characters.
BILLING SERVICES
  • Paid Through is set as expected when the “Set Paid Through” option is enabled under the VBA Control Panel.
CLAIM SERVICES
  • On the Ex Codes configuration screen, the HIPAA Code drop down will now display the HIPAA Code sorted by HIPAA Code instead of the description to be consistent with the way they are sorted by the screen if HIPAA Code is chosen as a sort criteria.
ENROLLMENT SERVICES
  • Added an ID Code for VBAGateway Registration Code. This value is used during the VBAGateway registration process for members to gain access to the site. See VBAGateway Services.
  • Added the option of No Other Insurance to the Priority list of Member Insurance. This will allow users to keep track when a member has no other insurance.
  • Added MemEnrollmentPlan to the tables available to be selected in an advanced search on the Member Search screen. Users need the ability to include MemEnrollmentPan in searches since SubEnrollmentPlan is not populated when benefits are configured at the member level.
PROVIDER SERVICES
  • Added an ID Code for VBAGateway Registration Code. This value is used during the VBAGateway registration process for providers to gain access to the site. See VBAGateway Services.
  • Added a configuration item for managing Practice Types. This field is informational only and has no functional use but can be used for reports. This will allow user to create their own Practice Types or to change the description associated with existing Practice Types.
VBA Control Panel
  • Added Use First Diag Reference as an Application Setting (Image 2).
  • Added a drop down for the user to select the Default EOB Report as an Application Setting (Image 2).
VBAdjudicate
  • Benefit matching logic will now check the flag Use First Diag Reference on the VBA Control Panel and if enabled will only match the diagnostic code identified by the first diag pointer

ALL NEW – VBAGateway Web Portal!

VBAGateway SERVICES VBAGateway Services are only enabled after a VBAGateway implementation is completed. Contact VBA for information about this exciting new product!
  • New services area added for communication with the VBAGateway site. This services area will facilitate the real-time transactions to and from VBAGateway. Included with the initial implementation of VBAGateway Services are automated actions around the following request types:
  • MEMBER TERMINAL:
    • Change Address – This request can be for the insured or for a specific member and will update the appropriate address information.
    • Add Coverage – This request will add the selected plan to the most current enrollment record that fits the defined effective date.
    • Terminate Coverage – This request will put an end date on the selected plan for thedefined termination date. This assumes the plan is active at the termination date.
    • Disenroll Member – This request will disenroll the selected member using the VBA disenroll process.
    • Add Member – This request will add a member to the selected family with the demographic information assigned.
    • Request ID Cards – This request will add the defined number of copies to the ID Card Request module within VBA.
  • PROVIDER TERMINAL:
    • Change Address – This request will update demographic information for the Provider.
    • Authorization – This request will create a VBA Authorization that can be utilized during adjudication.
  • Each Request can be approved or rejected:
    • Approved – Selected information is updated and response sent to VBAGateway. User can add Subject/Body information to the response if they like.
    • Rejected – User prompted with Subject/Body screen to enter rejection information which is sent back as a response to VBAGateway.

VBA Software March Madness Bracket Winners Announced

VBA Software March Madness had 25 participants in its first March Madness NCAA Bracket Challenge open to clients and outside contacts. The tournament had an number of upsets, as you would expect. It was truly exciting and the final result wasn’t reached until the final second of the Wisconsin-Kentucky game when Traevon Jackson’s shot for Wisconsin bounced out. No one picked the ultimate champion UCONN, which beat Kentucky in the championship game.

WINNERS – Each will receive a basket of delicious Wisconsin Cheese

  1. Jay Mason – Elli Health, AVIA Health Innovation, My Health Direct, Inc. – 89 points
  2. Brian Cox – JW Terrill – 86 points
  3. Tom Witter – VBA – 80 points

Champion Picks

  • Florida – 12
  • Michigan State- 6
  • Louisville – 2
  • Wichita State – 2
  • Arizona, Kansas, Wisconsin – 1

Thanks to all who participated. If you missed it, be sure to enter next year.

VBA NEW CLIENT UPDATE: Star Administrators

I am thrilled to share some exciting news with all of you: Star Administrators, which is located in Tampa, Florida has joined the Virtual Benefits Administrator (VBA) family of clients.

Star Administrators is among the few third party administrators capable of meeting the needs of both Medicaid and Medicare claims management. The principals have decades of experience and leadership in providing comprehensive health services, which enables them to cost-effectively employ state-of-the-art solutions as they help clients maneuver through the dynamics of today’s complex health care reform. The company operates nationwide and provides clients with a highly-trained, compassionate customer service team.

Star Administrators can now take advantage of VBA’s Flexibility, Functionality, and Technology to create much new efficiency. By using features like our process automation tool, hyperlink navigation, and offline auto-adjudication, VBA clients have experienced a reduction in variable overhead of over 50%!

FREE monthly updates and the flexibility of user–definable fields will allow Star Administrators to easily adjust to any market changes they may encounter. VBA’s software platform, which has been built with an eye on the future and is ICD 10 compliant, meets Star Administrators’ current needs and anticipated future needs.

You can now efficiently administer Life and Disability, Medical, Dental, FSA, HSA, HRA, COBRA, Vision and Medicaid/Medicare lines of business on one software system with VBA. For more information on VBA, visit our WEBSITE at http://vbasoftware.com or call me directly at 262-946-1210 or send me an email at twitter@vbasoftware.com.

Sincerely,
Virtual Benefits Administrator
Thomas W. Witter
President

ICD-10 Deadline Delayed One Year

The U.S. Senate voted to delay the deadline for ICD-10 compliance again from October 1, 2014 to at least October 1, 2015. The cost of this delay is estimated be between $1 billion to $6.6 billion dollars according to CMS. Combined with the first delay from October 1, 2013 to October, 2014, that would mean that between $2 billion and $13 billion dollars have wasted in the past two years – in addition to the original billions of dollars for the initial ramp-up costs spent throughout the health care industry.

While the additional time to achieve compliance is beneficial to some organizations, it punishes others who have already invested the time and money to achieve compliance. New standards almost always require an investment in new and improved technology, which quickly becomes an “expected” commodity. While “necessity is the mother of invention”, until utilized, it is waste.

Hopefully, those who sit in judgment of the U.S. healthcare system’s cost-effectiveness are wise enough to understand that dollars spent on healthcare delivery is only a fraction of what is paid by the patients, or users, of the healthcare system. We can all use a deduction for our expenses in the calculation related to our performance.

A major step in the solution to improving healthcare delivery and reducing its cost is to adopt cost-effective technology, which will deliver comprehensive and functional capabilities in a timely manner.

Tom Witter

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