Vistar eVIPs Review

Provides A Single Source Of Truth For Provider Credentialing

One essential aspect of provider management that Vistar eVIPs automates and optimizes is provider credentialing. This is the process in which payers, health plans, and managed care organizations verify if healthcare providers, medical practitioners, and physicians are qualified to deliver the services and procedures covered by the health insurance plans and programs they are implementing and receive reimbursements for those services and procedures. Background checks are performed on them so payers can check how knowledgeable and skilled they are, how extensive their experience is in their area of specialization, and how competitive they are.

Vistar eVIPs offers a credentialing management software solution that organizes all important provider credentialing information users need in a centralized database. The solution can gather credentialing data from multiple data sources and systems and display it on a dashboard. In addition, all pieces of information shown on the dashboard are automatically updated in real time, giving users a single source of truth as they handle information, processes, and tasks related to credentialing providers.

Create Automated And Configurable Provider Credentialing Workflows

The provider data management solution also enables users to implement provider credentialing procedures in a timely, efficient, and accurate manner. Vistar eVIPs allows them to set up and run provider credentialing workflows and configure such workflows by creating and defining their own set of business rules. They can build workflows that permit them to run background checks and verifications on targeted providers,  automate tasks for communicating and engaging with providers who are submitting applications and enrolling in health insurance plans, upload and attach documents to applications, and collect electronic signatures and finalize contracts.  

Flexibly Manage Your Network Of Providers

Vistar eVIPs provides payers, health plans, and managed care organizations with flexibility when it comes to handling their network of providers. They can access and monitor all important information about their providers and leverage it to formulate strategic claims and reimbursement management as well as billing plans and procedures. Additionally, the solution helps them ensure that they are able to adhere to all the things stipulated in their payer contracts as they implement provider network management procedures and manage their engagements and relationships with providers.

Measure And Analyze Provider Performance

The solution also makes it possible for users to measure and analyze provider performance. It offers quality management tools where they can access provider performance data collected from clinical systems, chart and review applications, and patient satisfaction-tracking tools. The data found in the quality management tools are automatically updated. This way, they can comprehensively explore provider performance data and gain insights into it much better.  Also, Vistar eVIPs lets them set and configure Key Performance Indicators (KPIs) and quality measurements that comply with HEDIS, CMS, NQCA, and URAC standards.

Enhance Interoperability Through Enterprise Integration

Vistar eVIPs is developed to seamlessly interoperate with a variety of data sources and systems. This is because the solution has enterprise integration features that transverse provider data across multiple sources and systems, enabling users to leverage their existing tools, avoid the need to maintain duplicate databases, and enhance their processes. For instance, Vistar eVIPs can pull in provider data coming from CAQH or Council for Affordable Quality Healthcare and CVO or Credentials Verification Organization.

Another enterprise integration feature built into Vistar eVIPs is that it enables users to electronically exchange information between systems and interfaces using HL7 or Health Level-7 standards. HL7 provides standard, uniform, and consistent ways of how administrative, clinical, and billing information should be transmitted across various healthcare systems. Because Vistar eVIPs uses HL7, multiple healthcare systems can seamlessly communicate with Vistar eVIPs and process information coming from the solution in a standard and consistent manner even if these systems are built based on different platforms and programming languages.