Payer Compass helps health plans drive down total claims solution spend by cutting through complexities and simplifying healthcare pricing.
Next-Gen Pricing Transparency and Contracting Solution VisiumТМ
Our transformational solution, Visium™, makes it simple to load and manage contracts, apply real-time edits and regulatory updates, and process pricing/repricing, helping you improve accuracy and reduce frustration. Visium™ can be configured to any plan’s goals, while also making it simple to automate reimbursement terms as you scale to accommodate multiple providers, contracts, groups, rate customizations and claim volume.
- Pricing & Editing Engine
- Contract Management
- Audit & Reporting
- Modeling & Analytics
Visium™ can handle health plans of any type, including Medicare, Medicaid, commercial, reference-based pricing, TRICARE, VA, and specialty types such as Tribal, indigent, and prisons. Visium™ also contains all methods of pricing, including CMS reimbursement, DRGs, and many others, so you can price any claim type.
Visium™ consolidates clinical editing, contract management administration and reimbursement methodologies all into one customer-centric, nimble resource.
You can submit information in flat file, EDI batching or using an API connection. Once all your contract data and payment terms are loaded, Visium™ matches the claim to the appropriate contract and then applies the correct contract edits and standard logic and reimbursement terms, plus any custom logic and reimbursement terms set by you. All of this is visible to you anytime through the platform portal.
Processed claims are returned in the submitted format for seamless workflow integration. Each claim has its own process trail that consolidates terms and edits, making it simple to confidently communicate with providers about how you arrived at the price and reimbursement amount. In addition, modeling, analytics and robust customizable reporting help you better review the data to meet your plan and operational goals.
Maximize your claim operations thanks to our unbiased, seamless workflow integration with nearly 30 EDI vendors and 23 unique claims adjudication systems and clearinghouses.Contact Us