Payer Action Center

Introducing our comprehensive toolkit for managing payer relationships

The question isn’t if payers will behave poorly; it’s when. And the answer isn’t to complain at the next JOC meeting. When you tell payers their decisions are unfair, their typical response is ”Prove It!”

For everyone who is responsible for holding payers accountable, negotiating payer contracts, and reducing delays in the adjudication process. Payer Action Center is the answer. It automatically identifies negative payer behavior trends, leading to increased recoveries. It uses crowd-sourced data to discover payer trends and misbehavior. It tracks escalations so you keep track of what you’ve put in front of payers. And it improves your ability to negotiate and defend your position in JOC meetings.

VisiQuate Payer Action Center is your one source of the truth for monitoring payer behavior, identifying trends and anomalies, escalating outliers, and benchmarking payer performance. It augments your payer scorecards with action that reduces the effort to get paid quickly.

Every day, Payer Action Center joins ATB, denial, and other disparate data sets together to identify trends, anomalies, and outliers. It applies proven VisiQuate Playbook rules to transform your payer scorecards into a live-action resolution center for immediate resolution.

Recoveries from the identified issues are applied directly to the escalated accounts; attributing 100% of the value to your efforts. New opportunity rules are created, shared, benchmarked, and acted on by member cohorts to exponentially expand the breadth of the solution. In all, it’s the most exciting innovation to hit revenue cycle since we helped you move off green bar reports.

Primary Features

• Toggle the action center by all payers, a single payer, or health plans
• View payer performance for rules that monitor for negative payer behavior
• Choose which rules to monitor
• Specify which payers are comparable to other payers for benchmarking KPIs
• Interact with A/R to baseline a bundle of AR that will be escalated to a payer
• Extract an A/R bundle so it can be sent to the payer
• Attribute large sum payments to the original A/R escalation bundle
• Track new baselines of payer performance after an escalation
• Administer periodically released new rules derived from VisiQuate

If you are interested in participating in our Payer Action Center Cohort program to be the first to get this, please email us at sales@visiquate.com.