Overview

Verus Health started with a clean slate and established the most efficient workflow processes in the industry, in a fully HIPAA EDI-compliant operation. This system redesign, combined with a highly experienced staff and very high levels of automation allow us to provide excellent customer service very efficiently. Full clinical logic editing incorporated into the core adjudication system insures accuracy in claim payment. First class Utilization Review, Case Management and Large Claim Management insure that claims are properly managed. National and regional Managed Care Networks and top-tier stop loss carriers, combined with industry-leading Rx and other vendor contracts provide the lowest net claims costs to plans administered by Verus Health. A full complement of online services, including fully integrated online enrollment, online report access, and vendor integration enhance operating efficiency and ease of use. Our objectives are to manage fixed costs and claims costs, reduce the impact of inflation trends, and simplify the work of Finance and Human Resource professionals.

Want to learn more? Contact us for a proposal.

Services

CLAIMS ADMINISTRATION

  • Medical:
    • Fully HIPAA EDI-compliant claim receipt and PPO Network Routing.
    • Full Clinical Logic integration to eliminate fraudulent or erroneous billing; Automatic review for inappropriate billing patterns and incompatibilities.
    • Auto Adjudication for efficiency and accuracy.
    • Prompt accurate and timely claim processing.

  • Dental:
    • Auto Adjudication for efficiency and accuracy.
    • Prompt accurate and timely claim processing.

  • Vision and Short Term Disability Administration.

Section 125/Flex Plans: Integration with medical processing allows for direct rollover of claims – one time submission ease for employees!

HSA/HRA.

COBRA/HIPAA Administration.

Broad billing and sub-accounting capabilities.

Integration with Life, LTD and other carriers for enrollment, consolidated billing.

Fully HIPAA Compliant Electronic Data Interchange (EDI):

  • Paperless communication between Verus Health and the Provider Community.
  • Speed, accuracy and efficiency, you can have it all.

Flexible Reporting with online access.

Online Web Access 24/7:

  • Claims – real time claim status.
  • Enrollment.
  • Reporting.
  • Administration & Maintenance.

Best in industry contracts:

  • Access to local, regional and national PPO networks.
  • Competitively bid stop loss with the best carriers in the industry.
  • Aggressive Pharmacy contract pricing; clients keep all available rebates.

Client-owned bank accounts – It is your money, after all…

100% of fees identified to clients.

  • Full Disclosure.
  • Integrity of Operation.
  • No Conflict of Interest.

No offshore service providers process any of our work at any stage.



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