Payer Compass | Health Plans

Contributors Output Visium™ Platform 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 prices any claim type with its rare gap fill advantage. Processed claims are returned in the submitted format, making workflow integration seamless. 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. Modeling, analytics, and robust customizable reporting is included in digestible formats to more easily compare plan outcomes to operational goals. Visium™ consolidates clinical editing, contract management administration, and reimbursement methodologies all into one customer-centric, nimble resource. 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. “The Visium ™ Process Trail puts everything together in a laymen’s form and shows the pricing formula for the claim. I can share it with a provider and stand on how I arrived at the reimbursement on the claim. I never had anything like that in all the different platforms I worked on.” VP, Business Integration | Client since July 2017 Our Transformational Visium ™ Solution EDI / Flat File API Claims, Contracts and Payments Employer Provider Payer Recognition While client success is our ultimate goal, we’re also proud to have our innovative company and team consistently acknowledged as leaders in the industry.