VBA Software - Reverse

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
img1

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
blockimg

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
computerimg

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
img5

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.

img2

Tired of Waiting for Your Claims Files to Process?

vbadjudicate

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.

  • Unparalleled Adjudication Speeds

  • Unlimited Parallel Processing Power

  • Run Claims Files of Any Size During the Day

  • Instantaneous Response for On-Demand Claims

Tens of Thousands

of claims processed in just a few minutes?

It’s possible with VBA.

VBA_LuminexFlyer_Mockup2

Increase Efficiency and Streamline Operations

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

quotes

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.

circle-img

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:

Group 160723

Provider Data Management and 1099 Services

Group 160725

PBM Services

Group 160727

Member and Provider Electronic Payments

Group 160724

Claims Editing and Repricing

Group 160726

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.

brochure