Avizzor Health Solutions

Maximizing Efficiency and Containing Costs

Avizzor Health Solution is the leading specialty benefit management company in Puerto Rico and South Florida for the business segments of implantable medical devices and specialty pharmacy. Maximizing Efficiency and Containing Costs.

 

SERVICES

What We Do

Business Consulting

With our consulting expertise, healthcare organizations can manage, optimize and transform their businesses to new, efficient business models.

  • Credentialing
  • Network Development
  • Provider Services
  • Member Services
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Clinical Services

  • Pre-authorization services based on CMS Local Coverage Determination and Insurance Medical Policies.
  • Medical Necessity screening.
  • For Specialty Pharmacy our clinical team will conduct a telephone interview with the patient to validate that the medication was administered as directed by physician (Adherence Monitoring).
  • Quality management and Outcomes (subjective and objective measures).
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Claims Services

  • Prepayment Reviews
  • Post Payments Review and Recovery process
  • Reimbursement Policy
  • Claims audit
  • Claims Processing
  • Claims payment
  • Benefits management
  • Pre-existing benefit exclusion Management

Training

We acknowledge that training is vital in any project success. That’s why we will train and guide thru the implementation process our client’s team members as part of our service.

SERVICES

Solutions

Clearing House

With our consulting expertise, healthcare organizations can manage, optimize and transform their businesses to new, efficient business models.

  • Credentialing
  • Network Development
  • Provider Services
  • Member Services

Data Analytics

We provide a value-based care performance management analytic system and Business Intelligence Tools that enables clients to:

  • Create Dashboards
  • Create customizable Reports
  • Identify patterns in Data to improve internal claim process
  • Prevent Overpayments
  • Optimize risk-based contracts
  • Reduce medical loss ratios
  • Improve the cost and quality of the healthcare system
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Claim Processing

We provides automated claims benefit adjudication for healthcare payers. The application supports straight-through processing of claims, enabling healthcare payers to significantly increase auto-adjudication rates by offering a wide range of configuration rules such as:

  • Flexible benefits,
  • Authorization validation
  • Duplicate claim (line) recognition,
  • Filing limit detection
  • Payment Policies based on individual HCPC/CPT
  • “Call out” rules that retrieve information from neighboring components.
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Security

Our Data Centers count on all the security, redundancy, and contingency guarantees necessary for continuous processing, regardless any unforeseen events. 100% HIPAA Compliance.

Transaction Types

  • Eligibility (270-271)
  • Claims (X12-837)
  • Receipt Notifications (277 and others)
  • Claim Status
  • Payment Explanation (835)

CLIENTS

Our Top Clients

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We're Here To Help!

Office

1400 NW 107 Ave. Suite 310
Miami, FL 33172

Call Us

Miami: 786.708.8394
Puerto Rico: 787.361.5066

Email:

support@avizzor.com