Technology

MediView uses the Virtual Benefits Administrator (VBA) administration system.

Our current claims processing system is comprised of fully integrated modules related to claims processing, plan design, enrollment, medical referrals and authorizations, providers, provider contracts, reinsurance and billing. VBA allows plan configuration to a great level of detail that will apply appropriate benefits and utilize either re-priced amounts from contracted networks or use a specific provider fee schedule and medical authorizations. The VBA system allows for high rates of auto- adjudication while meeting and exceeding accuracy and claim turn-around times.

  • MediView offers the option of using a third party, cloud-based vendor for claims editing; this software identifies unbundling, up-coding and other potential claim coding issues. Use of this software is integrated into the VBA system as part of the adjudication process and has reporting capabilities to show plan savings, error classifications and other financial data.
  • VBA has an extensive capability to configure covered and non-covered expenses and clearly explain the reason for any service denial. The explanation of benefits form (EOB) is customized to mirror plan specific appeal requirements for both members and providers. VBA has full capability to provide provider EFT’s and ERA’s, as well as issuing checks and EOB’s to both members and providers.
  • VBA is fully compliant for HIPAA and ICD-10.