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FOR COMMERCIAL HEALTH PLANS

Veda automates processes and provides accurate, real-time data for commercial health plans, helping build value-based care networks and reduce administrative burden. 

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THE CHALLENGE

Commercial health plans typically manage provider data manually, a burden on internal resources that does little to improve low-quality data. As a result, health plans experience claims fallout, poor member experience, and provider abrasion.

COMMERCIAL SOLUTION

THE VEDA SOLUTION

With Veda’s help, you can focus on building sustainable value-based care networks and reduce administrative burden and costs. The Veda platform provides quality data, which improves the provider and member experience and the auto-adjudication of claims.

  • Provider Data Automation

    Veda Velocity automates the roster intake process to format, review, verify, and update provider files in under 24 hours (guaranteed). Health plans can reduce backlog and minimize administrative costs, claims fallout, and provider abrasion using Veda’s best-in-class platform. With an accurate provider directory, health plans can improve their member experiences and maintain solid Star Ratings.

  • Roster Intake

    Your unstructured, disorganized, and incomplete provider rosters are uploaded to the Veda platform, where they are standardized in your preferred format, corrected, verified, and updated for your existing database. Veda increases data accuracy to 90% or above—resulting in improved member experiences and Star Ratings.

  • Accurate Billing

    Real-time data accuracy is necessary to keep members in-network and perform important billing tasks. Veda can reconcile and provide recommendations to update, remove, or add practice locations and validate demographic information and provider credentials to assist with faster claims. This helps health plans control costs and facilitate a better member experience.

  • Managing Specialty Provider Data

    Specialty provider data, notably for behavioral health, is uniquely challenging and inaccurate based on referrals, affiliations, volume of providers, and disconnected workflows. Veda works with health plans to stay atop changing information to make referrals, billing, and member access to quality care faster and more accurate.

  • Supporting Value Based Networks

    Constructing a low-cost, high-value network requires accurate, real-time data to build and maintain trust with providers. The data about the provider, facility, and contract needs to be valid everyday to keep accurate management of medical costs. With Veda’s data, you can trust that your directory is always updated with verified information.

  • Cost Reduction

    Bad data is expensive, and the cost of bad data can impact your entire organization, from IT and accounting to customer service and claims accuracy. Veda’s data quality improves auto-adjudication of claims and alleviates system-wide expenses, including administrative burden, cost of outreach (attestation, manual data fixes), and the cost of disenrollment.

  • Increase Member Satisfaction

    It's a competitive market for shoppers and disenrollment can be detrimental to your brand and revenue. Veda guarantees the most reliable data for your members, giving them the best information to access care, resulting in a positive and satisfying experience.

  • Network Construction and Provider Recruitment

    Expanding network offerings is critical for health plans to stay competitive and offer the best experience for members. Veda’s database is the most comprehensive source of providers available on the market. With access to over 3.5 million active providers—including physicians, nurses, allied health providers, behavioral health providers, pharmacists, and dentists—you can confidently grow your network and recruitment efforts.

  • Increase Network Adequacy

    Members need in-network provider options and geographic access to offer affordable and accessible care. Using Veda’s data can help health plans identify providers they aren’t currently contracted with and fill geographic or provider-type gaps in their network. With access to over 3.5 million active providers plans can meet the needs of members with in-network providers.

COMMERCIAL SOLUTION

THE VEDA SOLUTION

With Veda’s help, you can focus on building sustainable value-based care networks and reduce administrative burden and costs. The Veda platform provides quality data, which improves the provider and member experience and the auto-adjudication of claims.

Provider Data Automation

Veda Velocity automates the roster intake process to format, review, verify, and update provider files in under 24 hours (guaranteed). Health plans can reduce backlog and minimize administrative costs, claims fallout, and provider abrasion using Veda’s best-in-class platform. With an accurate provider directory, health plans can improve their member experiences and maintain solid Star Ratings.

Roster Intake

Your unstructured, disorganized, and incomplete provider rosters are uploaded to the Veda platform, where they are standardized in your preferred format, corrected, verified, and updated for your existing database. Veda increases data accuracy to 90% or above—resulting in improved member experiences and Star Ratings.

Accurate Billing

Real-time data accuracy is necessary to keep members in-network and perform important billing tasks. Veda can reconcile and provide recommendations to update, remove, or add practice locations and validate demographic information and provider credentials to assist with faster claims. This helps health plans control costs and facilitate a better member experience.

Managing Specialty Provider Data

Specialty provider data, notably for behavioral health, is uniquely challenging and inaccurate based on referrals, affiliations, volume of providers, and disconnected workflows. Veda works with health plans to stay atop changing information to make referrals, billing, and member access to quality care faster and more accurate.

Supporting Value Based Networks

Constructing a low-cost, high-value network requires accurate, real-time data to build and maintain trust with providers. The data about the provider, facility, and contract needs to be valid everyday to keep accurate management of medical costs. With Veda’s data, you can trust that your directory is always updated with verified information.

Cost Reduction

Bad data is expensive, and the cost of bad data can impact your entire organization, from IT and accounting to customer service and claims accuracy. Veda’s data quality improves auto-adjudication of claims and alleviates system-wide expenses, including administrative burden, cost of outreach (attestation, manual data fixes), and the cost of disenrollment.

Increase Member Satisfaction

It's a competitive market for shoppers and disenrollment can be detrimental to your brand and revenue. Veda guarantees the most reliable data for your members, giving them the best information to access care, resulting in a positive and satisfying experience.

Network Construction and Provider Recruitment

Expanding network offerings is critical for health plans to stay competitive and offer the best experience for members. Veda’s database is the most comprehensive source of providers available on the market. With access to over 3.5 million active providers—including physicians, nurses, allied health providers, behavioral health providers, pharmacists, and dentists—you can confidently grow your network and recruitment efforts.

Increase Network Adequacy

Members need in-network provider options and geographic access to offer affordable and accessible care. Using Veda’s data can help health plans identify providers they aren’t currently contracted with and fill geographic or provider-type gaps in their network. With access to over 3.5 million active providers plans can meet the needs of members with in-network providers.

You know your business. We know data.

Learn more about our products: Velocity Process Automation, Quantym Data Quality Scoring, and Vectyr Data Curation.

Velocity
Standardize and verify unstructured data with unprecedented speed and accuracy.

Quantym
Score and cleanse your network directory to identify areas that affect your quality metrics.

Vectyr
The most up-to-date, comprehensive, and accurate source of data on healthcare providers, groups, and facilities on the market.

BEST-IN-CLASS PROTECTION

Security Overview

Our approach to security helps clients face evolving risks and security challenges with complete confidence. Veda’s Smart Automation platform protects sensitive information through our comprehensive security controls, and meets key regulations and industry-defined requirements to effectively manage risk.

Security

Veda ensures that security is a central pillar of our operating procedures.

Reliability

Veda's Smart Automation platform is hosted entirely in the AWS cloud.

Compliance

Veda complies with all federal and state regulations where it operates.

Privacy

Veda places customer data privacy at the center of all decisions.

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CONTACT VEDA

Send us a message and we'll be in touch.

or call at 608-620-0733