VIDAPass Logo - Claim Scrubbing

Claim Scrubbing

Cloud-based EDI Gateway solution for health care payers, that can receive, clean and submit HIPAA compliant files

One of the administrative burdens for health plans and health care payers is to process all the EDI files that are being required. VIDAPass™ resolves this problem because it can receive as well as submit all the EDI files from Membership, to Claims, to Claim responses as well as Provider Directories. A second major burden is receiving “dirty” claims that can slow down claims processing and eventually cause Encounter Data submission problems. VIDAPass™ resolves this problem with a front-end rejection of transactions with critical errors. In addition, based on standard and user-defined rules and edits, corrects transactions with non-critical errors up-front before they are submitted to an adjudication system.

VIDAPass

Benefits

  • Reduces the percentage of human error and improves the number of clean claims submitted
  • Reduces the administrative costs associated with claims and encounter processing
  • 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
  • Provides a user interface of the EDI files

VIDAPass

Advantages

  •  Ability to reject Transactions for reasons such as:
    • Member eligibility
    • Provider participation
    • Invalid codes
    • Improper dates and date spans
    • Non-compliant State and or Federal billing regulations
    • Invalid Lines of Business
  • Ability to filter and clean data from other sources such as:
    • Eligibility files
    • Provider files
    • Claim files
    • Reference files
    • Core Admin files
    • Portal files
    • Third Party Vendor files
  • Serves as an EDI Gateway for core admin platforms
  • Cleans up Transactions which increases:
    • Claim Auto-adjudication
    • Cleaner Encounter data
    • Cleaner data for better fiscal reporting

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VIDAPass™ Datasheet

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