A cloud-based front-end claim scrubbing solution for health care payers, VIDAPass™ validates and edits claims pre-adjudication via a rule-based engine.
Current business environment requires health organizations to have more efficient operations. One of the administrative burdens for health plans and health care payers is to receive and accept claims that do not belong to them or have severe data deficiency. VIDAPass™ resolves this problem by front-end rejection of claims with critical errors. In addition, based on standard and user-defined rules and edits, it corrects claims with non-critical errors up-front before they hit the adjudication system.
- Reduces the percentage of human error and improves the number of clean claims submitted
- Enhances the efficiency and productivity of the adjudication process by increasing the first-pass clean claim rate and utilizing auto-corrections
- Increases the speed of claim processing
- Reduces the rate of pending claims and rework
- Reduces the administrative costs associated with claim processing and rework
- Distinguishes between critical and non-critical rules
- Only blocks bad claims with critical errors from submission and rejects them upfront
- Flags or corrects non-critical errors based on standard and user-defined rules
- Utilizes an advanced member-provider validation process
- Validates dates and codes
- Identifies duplicate claims based on submission history
- Customizable for client-specific rules and edits