FOR MEDICARE HEALTH PLANS
Medicare health plans can stay compliant and boost Star Ratings by automating processes and attaining better data with Veda.
THE CHALLENGE
Many Medicare health plans receive low-quality provider data that requires manual intervention. But this manual effort not only places time-consuming tasks on workers, it negatively impacts compliance, Star Ratings, and claims fallout - leading to poor member and provider experiences.
MEDICARE SOLUTION
THE VEDA SOLUTION
The Veda platform supplies Medicare health plans with quality data, then works within their system to continuously standardize and maintain that data. Our Medicare health plan customers improve the provider and member experience while staying compliant. Whether you need help with Data Accuracy, Compliance, Stars ratings, Administrative Burden, Claims Fallout, Provider Abrasion, or Member Experience, Veda has the right solution to solve your data needs.
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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.
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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.
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CMS Audit Compliance
Whether you need provider roster updates or an analysis of your full directory, our platform ensures you meet or exceed compliance benchmarks. Health plans can keep enrollment and Star Ratings in good standing, all while reducing data processing time by 98% and improving data accuracy to 90% or above.
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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.
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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.
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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 every day to keep accurate management of medical costs. With Veda’s data, you can trust that your directory is always updated with verified information.
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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.
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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.
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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.
MEDICARE SOLUTION
THE VEDA SOLUTION
The Veda platform supplies Medicare health plans with quality data, then works within their system to continuously standardize and maintain that data. Our Medicare health plan customers improve the provider and member experience while staying compliant. Whether you need help with Data Accuracy, Compliance, Stars ratings, Administrative Burden, Claims Fallout, Provider Abrasion, or Member Experience, Veda has the right solution to solve your data needs.
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.
CMS Audit Compliance
Whether you need provider roster updates or an analysis of your full directory, our platform ensures you meet or exceed compliance benchmarks. Health plans can keep enrollment and Star Ratings in good standing, all while reducing data processing time by 98% and improving data accuracy to 90% or above.
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 every day to keep accurate management of medical costs. With Veda’s data, you can trust that your directory is always updated with verified information.
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
Score and cleanse your network directory to identify areas that affect your quality metrics.
Use Cases & Resources
VIEW ALLBEST-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.
CONTACT VEDA
Send us a message and we'll be in touch.
or call at 608-620-0733