Visium™

Redefining Reimbursement

What is VISIUM™?

VISIUM™ turns wishful thinking into reality for operational efficiencies, revenue recovery, and management of your healthcare claims regardless of their affiliation – Medicare, Medicaid, Commercial, Reference-Based Pricing or Dual Eligible. This proprietary platform is a multi-faceted healthcare claim reimbursement platform consisting of health plan contract management, auditing and reporting, healthcare plan/claim modeling, and healthcare claim pricing/repricing.

Medicare reimbursement is the term used for the payments that hospitals or doctors are given in return for the care they administer to a Medicare beneficiary. The Medicare Reimbursement Rates are set by Medicare, and these rates are usually lower than the amount that is billed, or the amount that the healthcare provider would quote a private insurance company.

Who Benefits From A 4-in-1 Healthcare Savings Platform?

TPAs, Self-Insured and Brokers

Experience a seamless workflow, plan savings and increased satisfaction. VISIUM™’s flexibility and efficiency allows for integration with any client system or preferred adjudication partner. Accurate pricing results in a win-win with reimbursement savings of ~70% and increased revenue for the plan administrator.

Medicare Advantage, Health Plans, HMO's, PPO's, and RBP Plans

We deliver operations efficiency and peace of mind, taking the load off your shoulders to maintain the constant regulatory changes of 20+ Medicare payment methods, including CMS, and update them without operation interruption.

Medicaid and
Dual Eligibles

Payer Compass has mastered the state-to-state nuances of Medicaid pricing, alleviating this burden for our clients. For programs that need to comply with dual eligibility rules, we create transparency and reduce errors by supplying the appropriate allowed amounts and patient cost-sharing amounts for Medicare and Medicaid.

Commercial

Confidently face complex contract terms head on. Reduce the need to manually review claims and expedite claim payments with VISIUM™’s transparent, automated system.

Our Basis for Success? Pricing Claims at the True Cost of Care.

VISIUM™ is built to price any claim, using real Medicare rates and unique gap-fill capabilities for your most challenging medical claims.

Erase Payment Error
Wipe out overpayments with the accuracy of our in-house compliance team and precision system-edit accuracy

Web Portal Accessibility
Log in to our secure web portal from anywhere to view claim status, reimbursement amount and
applied edits

Claim Transparency
Gain quality assurance with the one-of-a-kind “Process Trail” to see how your claims are priced

Expedite Implementation
Get moving in weeks vs. months

Improve Operations Efficiencies
Even the most complex contracts, plan details and fee schedules are
loaded effortlessly

Scalability
We are built to grow with you, no matter how large or small the group

Your Claims, Your Way
We can accommodate claims in any format: EDI, 837 and API web services

Pricing Fairness
Unlike others in the market who sell Medicare programs a-la-carte, we believe you should get it all PLUS the power of choice and customization for one price

Making Impossible Possible
Using our unique gap-fill capabilities, we can price claims most others can't