The V3 System: Software for Insurance Administration
The V3 System Delivers:
  • Administrative Flexibility
  • Improved Customer Service
  • Extreme Scalability
  • Accurate and Timely Data
  • Self-Service Alternatives
  • Quality Correspondence
  • Operational Transparency
  • Value Added Reporting

The V3 System is a powerful solution for Health and Life administration.

The system's advanced capabilities include:

  • Health, Dental, Vision, Disability and Life
  • ICD9 and ICD10 Processing
  • Advanced Auto-Adjudication
  • Authorizations and Pre-Certs
  • Case and Care Management
  • HRA and HSA Processing
  • Payments and EOB's
  • HIPAA Interfaces

V3 Claims allows for the rapid configuration and administration of any number of plans for any mix of benefits across any number of groups and participants. The system unleashes the power of your organization by enabling rapid, accurate adjudication and payment processes using a powerful rules engine, advanced auto-adjudication features, and extensive options for automated claims imports and payment/EOB exports.

V3 Claims can be used stand-alone or in conjunction with other V3 components including V3 Enrollment and V3 Billing. Optional, native enterprise features including CRM, Self Service and Document Management capabilities ensure that the V3 System addresses both your internal operating requirements and your customer-facing service needs.

The V3 System is available as a traditional on-premise solution or as a SaaS application. Vitech's SaaS offering provides your organization with turn-key simplicity speeding time to production, simplifying operating requirements, and containing total cost of ownership.

The V3 System's powerful health claims processing features include:

    Demographics
  • Primaries and Dependents
  • Providers and Networks
  • Address Standardization
  • COB/Other Insurance Maintenance
  • Service Notes
  • Provider and Group Processing
  • Specialty and License Tracking
  • Coverage and Claim History
  • Payment and Document History
    Claims/Benefit Types
  • Medical
  • Hospital
  • Vision
  • Prescription
  • Dental
  • Life
  • Disability
    Reporting and Integration
  • Statements
  • Payment EOB's
  • Correspondence
  • Policy Holder Notices
  • End User Reporting
  • Ad Hoc Reporting
  • Tax Reporting
  • General Ledger Integration
  • Import and Export Processing
    Claims Processing
  • Manual Induction
  • HIPAA Set Induction
  • Image OCR Processing
  • Auto Adjudication
  • Manual Adjudication
  • Exception-Based Adjudication
  • Duplicate Checking
  • ICD Rules
  • CPT Rules
  • Modifier Rules
  • HRA and HSA Processing
  • COB Savings Bank
  • Authorizations
  • Surcharge Calculations
  • Network Pricing
  • Provider NPI
  • Utilization Management
  • Calculation logs
  • Integrated Workflow Processing
    Auditing
  • Statistical Sampling Based on Claim Criteria
  • Pre-payment or Post-payment Audits
  • Audit Workflow processing
  • Audit Error Reporting
  • Data Change History
    Rules-Based Adjudication
  • Configurable Formulas and Rules
  • Auto-adjudication Matrix
  • Deductible, Out-of-Pocket and Type-of-Service Limits
  • Definable Calendar Periods
  • Dollar, Visit and Unit Maximums
  • On-demand Accumulator Calculations
  • Coordination with Other Insurers and Medicare
  • Rule Segregation for Multi-Group Administration
  • Network Coverage Area Configuration
    Pricing
  • Internal Network Fee Schedules
  • Provider Contractual Fee Schedules
  • Real Time, External Pricing Interfaces
  • Reasonable and Customary Pricing
  • Bundling and Edits Integration
    Payments
  • Multi-Step, High Security Processing
  • Periodic or On-demand Check Processing
  • Checks, EFTs and Direct Deposit
  • Tax Withholding
  • Split Payment to Multiple Accounts
  • Support for Feeds to Third Party Payers
  • Liens and Levies
  • Over Payment Recoupment
  • Voids and Re-issues
  • On Screen Check Images

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