Invidasys' Health Plan Solutions Create Efficiencies for Chicago Managed Care Community Health Plan

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Family Health Network (FHN) Chooses Invidasys’ Composite-Based Software to Solve Encounter Submission Challenges, Patient Eligibility Data Management and More

Invidasys is willing to tackle big challenges and every single person on their project team is dedicated to finding solutions that address our pain points.

Invidasys, a software engineering firm that develops component solutions for health insurance plans, announced today that it has gone live with a number of solutions for Family Health Network (FHN), a not-for-profit managed care community network serving Chicago and Cook County, Ill.

FHN originally engaged Invidasys in March 2014 to utilize the company’s VIDACounter™ software solution, an encounter management system that generates Medicare and Medicaid compliant HIPAA 5010 837 encounter transactions and actually reviews and corrects non-compliant transactions prior to submission. VIDACounter™ automatically fixes errors in claims by reviewing rules set by the state, the Centers for Medicare & Medicaid Services (CMS) and the health plan. The solution automatically validates each encounter prior to submission to greatly reduce the likelihood of rejections, which helps avoid pay penalties for late and inaccurate submissions.

According to CMS, in 2013 the Medicare FFS program issued more than $36 billion in improper payments, and the Medicaid program issued more than $14 billion in improper payments.

Invidasys had its solution up and running for FHN in early July, taking less than four months to build, test and release. Typically, making changes to a health plan’s core administrative system means ripping the whole thing apart and replacing it with a new system, costing millions and taking years.

“Prior to working with Invidasys we faced numerous challenges around timely and accurate encounter submissions,” said Bryant Grimes, chief information officer for FHN. “We also were having difficulty because our patient eligibility information was housed in multiple data sources, and we were not able to model real-world provider network hierarchies and relationships.”

Grimes said that since the implementation of Invidasys’ VIDACounter™ solution just over a month ago, FHN is already experiencing reduced provider database maintenance, a quicker turnaround on processing state eligibility files, and significant improvements in the quality and timeliness of encounter processing.

“Our relationship with Invidasys is a partnership in the truest sense,” said Grimes. “They are willing to tackle big challenges and every single person on their project team is dedicated to finding solutions that address our pain points.”

Since implementing the VIDACounter™ solution, FHN decided to also move forward with utilizing other products from Invidasys’ VIDASuite™ of solutions, including VIDAPro™ (provider management), VIDABility™ (insured management), VIDAServe™ (customer service), VIDAFlow™ (workflow management) and VIDAFinance™ (financial management).

“This partnership with FHN is really a perfect example of how we can come into a health insurance plan, identify what the specific challenges and pain points are, and then we can devise a plan and implement our composite-based software solutions to fix the specific problems with the healthcare core administrative platform without replacing the entire system,” said Sherwood Chapman, co-founder and CEO of Invidasys. “This method allows clients to maximize the value of their core administrative system investment but gives them the flexibility to make changes that work specifically for their organization quickly and eliminates the high maintenance costs associated with the use of outdated technology.”

Invidasys can integrate its VIDASuite™ components with most health plan legacy core administration systems.

For more information or to schedule a demo, please visit http://www.invidasys.com.

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Melissa DiGianfilippo
Serendipit Consulting
since: 04/2010
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