Medical Claims Administration

VBA provides you with a claims platform that handles all of your needs

VBA Software Medical Module
VBA Software simplifies claims administration

VBA’s Medical module maintains both professional and institutional claim types with all required information. VBA incorporates thousands of built-in edits to verify and validate data in regards to eligibility, coordination of benefits, individual and family limitations, plan maximums, standard and custom benefit definitions, and accumulator data for current plan year and history plan years. A myriad of pricing capabilities including FFS, Per-Diem, DRG, Custom Provider Rate, , Adjusted Discount, and General Discount. VBA easily administers medical claims ranging from Medicare to Medicaid to Commercial brands using complex or simple plans defined through the Plan/Benefit Module.

Here’s how VBA Software + Services can help you:

VBA Software – Medical

  • Easily identifiable icons to navigate quickly between claims, as well as hyperlinks from the claim to Enrollment, Plan Set Up, Group Information and Provider Information. All of this is accomplished without the user needing to leave the claim screen.
  • Off-line adjudication processes/prices claims based on setup options including custom rates.
  • Handles coordination of Benefits (COB) at the claim level while using the Eligibility Module to track primary insurance.
  • Prints images in standard HCFA or UB format for any medical claim.
  • Tracks HIPAA specific x12 transaction information used when determining repricing source or when reporting Payor/Sender information for audits.
  • Windows based allowing unlimited number of working folders.
  • Setup Wizards throughout the application assist in creating the information you need.
  • Hyperlinks allowing easy access to needed information.

VBA Services – Medical

  • Provide pre-defined table and benefit structure to improve out-of-the-box functionality when implementing auto-adjudication claim rules.
  • Subject Matter Experts support, design and build unique benefit plans based on your specifications.
  • Support and process modifications for regulatory changes or support client customizations based on those regulatory requirements.
  • Dedicated subject matter experts with years of benefit administration experience will help you every step of the way.
  • Comprehensive training program tailored to your needs providing assurance you will become a VBA Software expert.
  • Detailed project management outlines the process, requirements, and milestones from implementation to post-go-live needs.
  • Provides a Business Process Improvement Plan to take your existing processes and gain new efficiencies with VBA Software.

About VBA Software

Virtual Benefits Administrator (VBA) is a pro-active, leading edge software design company providing custom solutions to the insurance industry for nearly 20 years. Uniquely delivered on a secure, cloud-based architecture, VBA provides one-common-architecture for all Employee Benefit Administration. Our software development process focuses on continuous improvement to address the requirements in the ever changing healthcare industry. This empowers our clients to focus on business strategy and growth while streamlining their operations. We bring over 150 years of combined experience in the design, development, and implementation of revolutionary solutions for a variety of clients covering a wide array of insurance offerings. Contact VBA now and request a live demo to learn more!

Now, you can perform all of your benefit administration in a single, easy-to-use application, accessible anywhere, anytime. With VBA software, you will eliminate the need for multiple software applications and multiple fees along with eliminating the cost and risk of combining and coordinating redundant member information. VBA is a flexible, cost effective solution for all aspects of claims administration and benefit management. Our software is designed to empower you with as much flexibility as possible with maximum functionality. VBA’s, open architecture and technology allow our engineers to create modifications and enhancements you might want to specifically fit your organization’s unique requirements, quickly and cost efficiently, thereby minimizing your cost.

Please fill out your information to learn more about the VBA Software Medical Module
Ready to schedule your free demo? Call us now at 1-866-731-1571.

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