Next-Generation Claims Administration Software
Your claims processing system needs to handle anything you throw at it—today and every day.
VBA’s secure, cloud-based administration software offers the ultimate flexibility in configuration.
With VBASoftware, your business can expand into new markets, automate manual processes and maintain compliance, all while delivering a better customer experience.
Cloud-Based Claims and Benefits Administration Software
Revenue Cycle
Management
Maximize revenue from the time a claim comes in the door through completing the payment to the provider and any reinsurance claims.
Flexibility to manage a wide variety of claim types seamlessly, including medical, dental, vision, HRA/HSA, flex plans, life, disability and more. Full audit and suspense modules ensure accurate and efficient processing.
Define any number of fee schedules and pricing structures and assign them by network and effective date to any number of provider records.
Configure and assign rates individually or en masse, across your entire business. Plus, everything you need to pay a claim from requesting funds, through cutting checks, to electronic transactions.
One of the most comprehensive reinsurance modules in the industry that can accommodate almost any plan or benefit design. Detailed configuration of member-specific deductibles, lasers, claim exclusions, tier factors, reinsurance levels and more.
Care
Coordination
All the tools you need to manage utilization, track appeals and grievances and provide intensive support for your high-risk populations.
Create care units, assign care managers and develop comprehensive care plans with no limitation on design.
Review and approve authorizations and referrals manually or automatically based on user-defined clinical criteria. Authorization information is tightly coupled with claims adjudication for efficient and accurate processing.
Track all aspects of a grievance or appeal along with any associated notes, unique codes and documentation.
Provider and Network
Management
Build and maintain your provider networks and capture the necessary data for contracting, credentialing, provider directories and provider payments.
Manage provider data including demographic information, provider types, specialties and languages. Manage provider pricing for fee schedules, contracted rates, DRGs, per diems and more.
Track all essential credentialing information including quality, attestations, licensing and related documentation. Maintain an audit trail for accreditation and other regulatory requirements.
Arrange payments for physicians, hospitals or other healthcare providers based on a PEPM or PMPM contracted rate for a defined population that can be adjusted for age, gender, severity of illness and/or regional differences.
Configuration
Services
Build plans, configure benefits and enroll subscribers and dependents with ease, all while maintaining a full audit trail.
The ability to enroll members in one or more benefit plans and tier combinations and track accumulators, beneficiaries, bank accounts, invoices and more.
Configure benefits for individuals and groups to control every aspect of claims payment and auto-adjudication. Manage plan, tier and network offerings along with any number of unique divisions.
Limit access to data and reports through user-defined security areas. Manage user logins and passwords and track user activity with full user logging and audit functions.
Get More from Your Claims Processing Software
Dive Deeper with
260+ Reports
Run your operations with greater efficiency with more than 260 canned reports and SQL access to your data for ad-hoc reporting.
ENABLE INTEROPERABILITY
Through APIs
Seamlessly connect your VBA solutions to other internal and external systems to share data in real time.
Tired of Waiting for Your Claims Files to Process?
VBA is leading the industry with VBAdjudicate, our new lightning-fast claims adjudication engine that harnesses the power of serverless computing to make your claims processing more efficient.
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Unparalleled Adjudication Speeds
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Unlimited Parallel Processing Power
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Run Claims Files of Any Size During the Day
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Instantaneous Response for On-Demand Claims
Tens of Thousands
of claims processed in just a few minutes?
It’s possible with VBA.
Boost Efficiency and Gain a Competitive Edge
Watch the video to learn about the latest enhancements to VBASoftware.
Transform Your Business with Next Generation Technology
There are many benefits to upgrading your outdated systems to VBA’s modern, cloud-based claims administration platform.
Learn how VBASoftware compares with other solutions in the market.
What Our Clients Are Saying
VBA has a very easy-to-use and flexible interface with numerous shortcuts and navigation options that have allowed us to streamline our training process. What we have learned is that VBA helps the user become an expert at what they do. This creates a more knowledgeable and productive employee who can be a better steward for our clients.
~Michelle Bounce
President
J.P. Farley
Take Customer Service a Step Further
All the tools you need to effectively and efficiently provide service to your customers. Includes full call tracking, notes and document management capabilities. Easy navigation to enter information into the application allows your customer service team to be more productive and effective.
Optimize Workflows with Automation
Define workflows and increase productivity for all your teams. Automate manual processes for more efficient operations, freeing up your staff to focus on the more complex transactions.
Extend Your Technology Capabilities
Go further with VBA’s partner integrations for specialized solutions and services. All of our partners are fully integrated with VBASoftware for a seamless experience.
Here are just a few of the features you can add by turning on one of our fully integrated VBA partner solutions:
Provider Data Management and 1099 Services
PBM Services
Member and Provider Electronic Payments
Claims Editing and Repricing
Fraud, Waste and Abuse Protection
Get Started
Ready to see how VBASoftware can help your business run more efficiently?
Download our brochure or schedule a demo today.
