Avizzor Health Solutions
Maximizing Efficiency and Containing CostsAvizzor 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
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).
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
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.
Security
Our Data Centers count on all the security, redundancy, and contingency guarantees necessary for continuous processing,
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