FLEXIBILITYFUNCTIONALITYTECHNOLOGY

vbasoftware.com

VBAVirtual Benefits Administrator

"VBA has a very easy-to-use and flexible interface with numerous shortcuts and navigation options that have allowed us to streamline our training process. What we have learned is that VBA helps the user become an expert at what they do. This creates a more knowledgeable and productive employee who can be a better steward for our clients." Michelle Bounce Chief Operating Officer, J.P. Farley

Welcome to the Future of Benefits Administration Technology

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Enterprise software is at the heart of any payer organization, regardless of what lines of business it administers. When it works, it’s an integral part of an organization’s success, but anyone who has lived through an enterprise solution gone wrong knows the nightmare it can create. We hear too often of those “over-promise, under-deliver” solutions in the enterprise technology space.

At Virtual Benefits Administrator (VBA), we think it’s time to wake up from the nightmare.

VBA gives you a proven platform that is designed to deliver critical functionality at a price that fits your organization’s needs.

• Member & Eligibility

• Customer Service

• Claims

• Billing

• Technology

• Manage External Interface Interactions

Our software is completely cloud-based, eliminating security risks and allows you to administer your business no matter where your office is for the day.

VBA offers two products that can work together or standalone.

VBAVirtual Benefits Administrator

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VBAGateway

VBAGateway is our enterprise engagement platform with an easy to use interface for Members, Employers, Providers, and Brokers/Agents. VBAGateway has been designed with a focus on user engagement while delivering on VBA’s core philosophy of flexibility, functionality, and technology.

VBASo�ware

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Meeting Payer Needs

Core Functionality of VBASoftware

MembershipEnrollment Services Enroll members in any number of customized plan and tier combinations while maintaining extensive details for accumulators, disability, bank accounts, invoices, and much more.

Benefit Services A highly flexible and dynamic application for plan and benefit construction that allows you to control every aspect of claims payment and auto-adjudication.

Group Services Experience a wide variety of setup options and configuration, including plan, tier, and network offerings along with any number of unique divisions.

Customer ServiceCall Tracking Services Full call tracking, notes, and document management capabilities. These functions, paired with easy navigation to key data in the application, allows your CSRs to be more productive and effective.

Grievance ServicesTrack all aspects of a grievance along with any associated notes, unique codes, and documentation.

ClaimsAuthorization Services VBA authorization information is tightly coupled with adjudication, which allows for automatic assignment and satisfaction of approved authorizations.

Claim Services VBA gives you an easy-to-use claims platform that handles a wide variety of claim types seamlessly. In addition, there is a full Suspense Module and Audit Module for additional claims management. • Medical• Dental• Vision• HSA | HRA | Flex• Disability• Life• Other (Retirement, etc.)

Reinsurance Services VBA Reinsurance Services allow you to define contracts to the Group, Division, or Subscriber level, along with any number of defined claim criteria. Lasered deductible, tier factors, aggregate specific members, and reinsurance leveling for life claims allow you to handle any plan design that your operation encounters.

Care Management Services VBA offers a complex and all-inclusive care management module. Maintain care managers and care units responsible for user configurable care plans with no limitation on design.

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Core Functionality of VBASoftware

BillingBilling Services Premium billing can be a cumbersome and maddening aspect of administration. We provide configurable settings for rates that can be assigned dynamically, individually or en masse, across your entire business.

Accounting Services Everything you need to easily carry a claim through the entire funding process from requesting funds, through cutting checks, to electronic transactions.

SecuritySecurity Services Each object and report can be restricted to Admin, Update, or View access through user defined security areas. Secure data within those objects and reports with data level security provided by VBA Security Services.

User Services Manage passwords, name, and demographic information along with user logging and auditing. This logging process allows you to track when a user logs in or out of the system, when they went idle, what screens they visited, and what information they searched.

Provider FilesCredentialing Services Track all essential credentialing information including quality, attestation, licensing, and documentation. Feel comfortable knowing that all your historical information is stored for audit.

Provider Services Manage provider data including demographic info, provider types, specialties, and languages. Manage provider pricing for fee schedules, contracted rates, DRG, per diems, and more.

Fee Schedule Services Define any number of fee schedules and pricing structures and have them assigned by network and effective date to any number of provider records.

Capitation Services Use our capitation module to allow a physician, hospital, or other healthcare provider to be paid a contracted rate based on a defined assignment. This assignment is fully configurable on a PEPM or PMPM basis adjusted for age, gender, illness, and/or regional differences.

Additional BenefitsNotes Services This dynamic and customizable service allows for unlimited tracking of notes and document information.

Report ServicesMore than purely report printing, VBASoftware includes two hundred reports with fully exposed SQL that your report writers can use and customize in their favorite report writing tool. Save your reports as PDF or in a number of exportable formats such as XML, CSV, Text, or HTML. Schedule reports or track letters for correspondence tracking using VBA Report Services.

System Services Control all aspects of VBASoftware in one central location. Manage your Explanation Codes, Auto-Adjudication Settings, Process Automation, and much more.

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Experience Connection without Limits with VBAGateway.At VBA, we recognize that interoperability is a real issue plaguing the healthcare market and immediacy and solutions that support immediacy in healthcare is a real need. As a leading-edge software company, we provide real-time portal solutions for the healthcare payer market.

VBAGateway is portal services at its best. As an all-encompassing, cloud-based platform, VBAGateway is designed to connect you with your members, providers, employers and brokers, all in real-time.

Based on Google’s user experience design principles, our portals are configured to deliver real-time information and notifications and built-in gamification work-flows to reward users and create loyalty.

Most importantly you can gain efficiencies by integrating your best-in-class solutions into our platforms resulting in the highest level of user engagement and you save time and money with a quick and efficient implementation.

The digital user experience platform you need–zero hassle.

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A Better Design, From A Better Partner.At VBA, we understand the needs of those you serve. We also understand and place great weight on your business needs.

You care about quality We deliver the highest quality portals, featuring robust functionality and the latest in cloud-based technology.

Price matters We add immense value through true configuration, not customization.

Your experience matters You gain a best-in-class solution and a dedicated IT and development team to best meet your business needs.

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VBAGateway has four portals, designed from the ground up to provide extensive self-service capabilities

to individuals based on their unique role.

• High quality portals that connect seamlessly to any platform

• Costandresourceefficienttoolforyourbusiness

• Fully implemented and functional portals in an average of 90 DAYS

• A dedicated partner – we win when you win, you winwhenyourbusinesswins

• EOB Downloads• Temporary ID

Cards• Administrative Messaging• Claim Lookups• Open Enrollment

• Insights & Analytics• Online Enrollment

Configuration & Setup• Plan Population

Information

• Eligibility Status• Claim Status• Authorization• Claim Entry • Insights & Analytics

across multiple books of business

• Commission Payment Information

Provider Portal

Member Portal

Employer Portal

Broker/ Agent Portal

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What can your company gain from VBAGateway?

Medical Dental Vision Medicaid Medicare

Key Features & Functionality:

• Intuitive design

• Robustself-servicecapabilities• Comprehensivedashboardsandreporting

• Limitlesswork-flowmanagementcapabilities• Real-timeconnectivitywithyourcore

administration system

• Mobilefriendlyconnectionfromanywhere

Scalable Portal Solution for Administration of:

Putting the Real inReal-time Connectivity.

The future is now with VBA’s real-time connectivity. VBAGateway delivers the modern, instant connection you’ve been waiting for by integrating with ease into your current platform. This connectivity permits a level of instant communication you’ve never experienced with your members, providers, employers and brokers by allowing you to respond immediately to any user within VBAGateway.

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Increased Administrative EfficienciesOur portal provides the ability to upload health related documents for members, providers, brokers and employers to access, view and download in one place - saving time and reducing costs.

Latest Software at Your FingertipsOur software is updated upwards of ten times per year, ensuring you get the best software and functionality with no additional fees. Plus, our fully integrated web portals are mobile friendly, allowing for anytime, anywhere access.

Vetted & Verified VBA is a software solution for major leaders in the Payer BPO segment and is verified in Gartner’s Top Core Administrator Survey for 2016 and 2017.

Security & EaseAll data hosted by VBA is securely stored in the cloud, fully encrypted in transit and at rest, with no PHI residing on machines. VBA software is HIPAA & SOC I Compliant, with SOC II Mapping Underway and Tier 1 Vendor classification for United Healthcare.

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Help Your Members Get Plugged-in to the Future of Healthcare with VBAMobile.

The VBAMobile home screen summarizes a member’s latest activity and allows quick navigation to additional details.

• Real-Time Communication

• ID Card and Plan Details

• Most Recent Claims • Benefits Used &

Remaining

Access details to member claim information across all covered plans in a single, easy-to-navigate claims list.

• Service Details by Claim

• Sort and Filter Options

• Claim Type & Status Indicators

• Service Provider Details

View plan details and network participation, as well as additional eligibility information to support ID card needs.

• Eligibility Information • Plan Participation • Network Available • Download ID Card

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VBAMobile, powered by VBAGateway, is innovating the healthcare industry as a conveniently accessed, intuitive self-service mobile tool. With VBAMobile, your company’s members are plugged-in to an industry leading Member Self-Service Mobile App. Through VBAMobile your members can perform numerous self-service functions, in real-time, that would normally require management or administrative oversite. You save time, human capital resources and money. Member self-service through the VBAMobile App eliminates cumbersome manual processes, phone calls, and paperwork resulting in real, tangible savings by the administrator.

Implementation Horrors No More

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Haunted by the potential of a system conversion nightmare with thousands of problem logs and never ending bug fixes?

Not anymore.

When it comes to new systems, especially something as critical as your enterprise membership, billing, claims, and customer service systems, you need a solution that gives you a smooth transition and quick fulfillment. VBA clients across the country have experienced seamless implementations time and time again.

How do we do it?

VBA has a methodical approach to implementations so nothing is left to the last minute, to better help your business stay ahead of the curve. You’ll receive a dedicated project team to keep your implementation running on-schedule with regular communication and status reports. VBA also provides an extensive client training period, so when the switch is flipped, your employees are able to hit the ground running.

Don’t work for your system. Make it work for you.

You can experience implementation in as little as 90 days depending on the complexity and scope of your organization’s needs. At VBA, one size does not fit all and we will work to ensure your implementation and new system work for you.

Virtual Benefits Administrator (VBA) is a proactive, leading edge software design company providing custom solutions to the insurance industry for nearly 20 years. Uniquely delivered on a secure, cloud-based architecture, VBA provides one-common architecture for all Employee Benefit Administration. Our software development process focuses on continuous improvement to address the requirements of the ever-changing healthcare industry. This empowers our clients to focus on business strategy and growth while streamlining their operations. Visit vbasoftware.com to learn more.

Stop living the nightmare of a patchwork system today.

Contact VBA now and request a live demo to see what great enterprise technology looks like.

VBAVirtual Benefits Administrator

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