Monthly Archives: March 2017

VBAGateway March 2017 Release Notes

MEMBER TERMINAL

  • Member Accumulators will now show additional years even if there is no Claim data associated with that year.

PROVIDER TERMINAL

  • No changes

EMPLOYER TERMINAL

  • Enrollment Periods can now be marked as “New Hire Only.” Enrollment Periods that are marked as “New Hire Only” will only be available for Registration. These Periods will not prompt Members that they are in an Open Enrollment Period. To set a Period as “New Hire Only,” use the Enrollment Settings Screen (Config>Enrollment) (Image 1).
  • Plan Options have been expanded (Config>Plan Settings) (Image 2).
    • Allow Flex Election Entry
      1. Flex Election Minimum
      2. Flex Election Maximum
    • Allow Life Volume Entry
      1. Life Volume Minimum
      2. Life Volume Maximum
      3. Life Volume Increment
        • The increment by which Life Volume increments in Open Enrollment.
  • Plan Description Override
    1. Text in this field will be used in Gateway instead of the traditional Plan Name. To use the traditional Plan Name, leave this field blank.
  • Hide on Employer Terminal
    1. Check this box to hide this Plan in Plan lists on the Employer Terminal. An example is the Census Employee Information POD.
  • Hide on Member Terminal
    1. Check this box to hide this Plan in Plan lists on the Member Terminal. An example is the Employee Information POD, and the Member Information Card.
  • Changed the “Paid” column header to “Payable” on the Employer Home Screen>Top 5 Benefit Category Utilization + Remaining POD to better describe the data in that column.

OPEN ENROLLMENT

  • No changes

VBAGATEWAY GLOBAL (ALL TERMINALS)

  • No changes

Image 1 – New Hire Only Option

Image 2 – Expanded Plan Options

VBA Included in 2017 Gartner Market Guide for Healthcare Payers Core Administrative Processing Systems

Get your 2017 Gartner Market Guide for Healthcare Payers Core Administrative Processing Systems today: click here to download your guide.

Inside your 2017 Gartner Market Guide for Healthcare Payers’ Core Administrative Processing Systems you will find recommendations and market information regarding the Healthcare Administration Software industry. This guide will help your team as you decide on a benefits administration system.

Disclaimer for Report:
Gartner, Inc., Market Guide for Healthcare Payers’ Core Administrative Processing Systems, Constance Sjoquist, 10 March 2017.
Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

VBA Software March 2017 Release Notes

AUTH SERVICES

  • Added the Auth Type Places section to the Auth Types configuration area.  This allows Auths to be determined by Place of Service (Image 1).

BENEFIT SERVICES

  • Copying a plan will properly copy annual and lifetime max amounts.

CLAIM SERVICES

  • Added new fields to the CLAIMPROCESSDATEUSER table under criteria options for Claim Audits.  The new fields available for selection will allow audits to be performed based on the activity within the VBA Workflow Services area (Image 4).

GROUP SERVICES

  • Added a new message when reenrolling a group asking the user if they wish to only reenroll members that were disenrolled with the group.

PROVIDER SERVICES

  • Modified the functionality of the Alternate Provider list to not ask the user if he would like to synchronize in the situation where nothing has been modified.
  • When the user unchecks Apply Ex Code under Network Configuration, if an Ex Code was selected prior, it will no longer be used.

REINSURANCE SERVICES

  • Deleting a Reinsurance Contract will no longer behave abnormally in some instances.

SECURITY SERVICES

  • Modified User Restrictions to allow for exclusions.  The Restriction – Group, Restriction – Fee Schedule, Restriction – Provider, and Restriction – Network tabs on the User Restriction screen have an option to Exclude (Image 3).

PROCESS AUTOMATION

  • Modified the appearance of Process Automation Template Arguments.  This gives more clarity to the arguments assigned to each Process Automation trigger (Image 2).
  • Added a new Process Automation Trigger – Check Process by Check.  This new trigger will fire for each check within a Claim check run.  This trigger has the following parameters:
    • ach_account_name – For “payment_method” = FWT, this is the account name for who is being paid.
    • ach_account_number – For “payment_method” = FWT, this is the account number for who is being paid.
    • ach_bank_name – For “payment_method” = FWT, this is the bank name for who is being paid.
    • ach_routing_number – For “payment_method” = FWT, this is the routing number for who is being paid.
    • check_account_key – The Account Key on this Check.  This is the internal Account Key value for the source of funds.
    • check_batch – The Check Batch identifier for this Check Run.
    • check_batch_date – The Paid Date for this Check Run.
    • check_batch_description – The Description assigned to the Check Batch for this Check Run.
    • check_claim_count – The total number of claims paid on this Check.
    • check_date – The Check Date value for this check.
    • check_id – The Check ID value for this check.  Check ID is the internal ID used to identify a unique check.
    • check_number – The Check Number value for this check.  This is the number you see on checks, EOBs and reports.
    • check_paid – The Amount Paid on this Check.
    • check_payor_id – The Payor ID on this Check.  This is the internal Payor ID value for the source of funds.
    • check_run_check_count – The total number of checks paid in this Check Run.
    • check_run_claim_count – The total number of claims paid in this Check Run (includes denied claims and $0.00 payable claims).
    • check_run_paid – The total amount paid on all checks in this Check Run.
    • payment_method – This identifies how the Check was paid.  CHK = Check Cut, FWT = Wire Transfer
    • payto_address – The Pay To Address for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Address, B = Beneficiary Address, S = Subscriber Address, V = Provider Address, P = Payee Address
    • payto_address2 – The Pay To Address2 for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Address2, B = Beneficiary Address2, S = Subscriber Address2, V = Provider Address2, P = Payee Address2
    • payto_city – The Pay To City for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group City, B = Beneficiary City, S = Subscriber City, V = Provider City, P = Payee City
    • payto_email – The Pay To Email for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Email, B = Beneficiary Email, S = Subscriber Email, V = Provider Email, P = Payee Email
    • payto_id – The Pay To ID for this Check.  Based on the “send_check_to”, this value holds different IDs.  G = Group_ID, B = Beneficiary_ID, S = Subscriber_ID, V = Provider_ID, P = Payee_ID
    • payto_name – The Pay To Name for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Name, B = Beneficiary Name, S = Subscriber Name, V = Provider Name, P = Payee Name
    • payto_state – The Pay To State for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group State, B = Beneficiary State, S = Subscriber State, V = Provider State, P = Payee State
    • payto_state_name – The Pay To State Name for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group State Name, B = Beneficiary State Name, S = Subscriber State Name, V = Provider State Name, P = Payee State Name
    • payto_zip – The Pay To Zip Code for this Check.  Based on the “send_check_to”, this value holds different names.  G = Group Zip Code, B = Beneficiary Zip Code, S = Subscriber Zip Code, V = Provider Zip Code, P = Payee Zip Code
    • send_check_to – This is who the check is being sent to.  G = Group, B = Beneficiary, S = Subscriber, V = Provider, P = Payee
    • ReportArg_AccountKey – Account Key for reports in this series.
    • ReportArg_CheckBatch – Check Batch for reports in this series.
    • ReportArg_CheckID – Check ID for reports in this series.
    • ReportArg_PayorID – Payor ID for reports in this series.
    • ReportArg_PayToID – Pay To ID for reports in this series.

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VBA New Client Update – Employee Benefit Systems

I am proud to announce that Employee Benefit Systems (EBS), which was established as a Third Party Administrator (TPA) in 1984 in Burlington Iowa, is now a member of the Virtual Benefits Administrator (VBA) family of clients.


Employee Benefit Systems (EBS), established as a Third Party Administrator (TPA) in 1984, prides itself on providing a full range of high-value insurance and administrative services to meet our customer’s needs.  EBS creates customized plans for your organization allowing for affordable benefits to your employees while controlling your costs and keeping your benefits running smoothly.

EBS has the capability to tap into the expertise and resources of our affiliated entities as needed to provide our customers with superior services at maximum value. EBS is a flexible, low-cost, high integrity, responsive firm eager to build a relationship with your organization while Helping Administer Your Success!

Because of the VBA Application’s features like process automation, hyperlink navigation, and offline auto-adjudication, EBS has gained a significant increase in efficiency!

They have also chosen the VBAGateway as their web portal. VBAGateway features the latest web technologies and architecture like SPA (Single Page Application), Responsive Design, Gamification, Intuitive Help, and POD (Personalized Object Data).

You can 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 and VBAGateway, 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

P.S. For more information about EBS, see their website at http://www.ebs-tpa.com

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