Healthcare Payer Solutions With Vim
For Payers

Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions.

Vim’s next-generation clinical workflow integration technology is the leading healthcare payers solution. The leading health plans leverage Vim’s middleware technology and provider engagement platform, Vim Connect, to surface their data, insights, and applications where provider care teams are already working – within EHR workflows.

Lower administrative burden and drive behavior changes on value-based workflows. Engage providers on prior authorization workflows, high-value referral selections, quality score performance, and suspected diagnosis review. Plus, surface patient-specific health history and insurance benefits in one place – at the point of patient care.

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Lower administrative burden – engage providers.
Choose applications that will drive the most value for your provider network while helping you achieve your organizational goals. Close diagnosis gaps, influence referrals, streamline prior authorization and more by alerting care teams at the exact right moment in their EHR workflow.
Deploy new applications seamlessly with no additional set-up.
Vim’s proprietary integration and connectivity process with “over-the-air” deployment capabilities allows payers to scale roll-out and choose additional applications to add to the provider experience at any time - with no additional set-up.
Remove EHR compatibility from your checklist.
Vim’s lightweight integration process is easy and fast for provider groups - go live in weeks with no third-party dependencies or costs.

Vim's point-of-care connection platform is trusted by leading health plans and risk bearing entities, and hundreds of provider organizations of all sizes across the U.S.

  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
  • Connect data to clinical workflows at scale with Vim's in-EHR healthcare payer solutions. - Vim
Why leading insurers and care delivery organizations choose Vim Connect's healthcare payers solutions:
Hit performance targets - up to 90% engagement on gap closure workflows.
Hit performance targets - up to 90% engagement on gap closure workflows.

Vim connects gaps to patient context within the EHR and automates steps in the workflow to enable better gap closure performance, thus improving quality scores and risk adjustment accuracy.

Free physicians and their teams from spreadsheets.
Free physicians and their teams from spreadsheets.

Vim Connect applications take phone calls, spreadsheets, portals, and secure emails out of the equation. Seamlessly put the data your providers need right where – and when – they need it. Save care teams time and effort and free them to focus on patients.

Gain real-time performance visibility.
Gain real-time performance visibility.

Physician engagement with your data is only one part of the equation. Vim’s real-time reporting and write-back capabilities mean your operational teams have more visibility into performance across your network. Understand in-app behavior to uncover performance opportunities, flag providers that need more support, and inform your business decisions. With more accurate information for your risk-bearing portfolio, you can better manage your financials and provider relationships.

A uniquely powerful connection of data to workflow
A uniquely powerful connection of data to workflow
Low lift integrations
Low lift integrations

Our technology enables the simplest and fastest integrations in the industry. We connect to provider EHRs in a matter of days, often with near zero lift from provider teams.

Dynamic, advanced workflow capabilities
Dynamic, advanced workflow capabilities

Vim applications target the precise moments where data can be connected to workflows and automates previously manual tasks.

Bidirectional feedback
Bidirectional feedback

We provide detailed insights into user behavior in real time, giving visibility into actions taken, gap responses, and individual or practice level performance.

Vim Connect Applications

Vim Connect applications embed directly into provider EHRs to drive accelerated provider performance and enhanced patient experience. Click below to explore all the healthcare payer solutions available on Vim Connect to power in-EHR workflows across more than 2,000 provider organizations:

Diagnosis Gaps
Enhanced Eligibility
Order Assist
Patient Health History
Prior Authorization
Care Gaps
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Trusted by leading payers and providers

By integrating Stellar’s value-based actions and real-time incentives into Vim’s in-EHR workflow solution, we expect to significantly increase engagement and improve performance across our practice network by making it easier for providers and teams to access the right information at the right time. The ability to deliver high-value incentives and opportunities at scale during patient encounters is an exciting step forward for our product and mission. quote
Michael Meng

CEO, Stellar Health

Trusted by leading payers and providers

Trusted by leading payers and providers

Since our inception, Availity has been dedicated to helping payers and providers overcome the administrative barriers that have for too long stifled their ability to collaborate effectively and efficiently. We are pleased to establish this collaboration with Vim in the next step of our mission to break down payer-provider communication siloes. quote
Russ Thomas

CEO, Availity

Trusted by leading payers and providers

Trusted by leading payers and providers

We're thrilled to see these two companies come together and combine their innovative technology and industry relationships to drive value. Availity and Vim have an impressive technology stack and we're excited to see how their partnership transforms healthcare. quote
Chuck Divita

EVP, Commercial Markets, GuideWell

Trusted by leading payers and providers

Trusted by leading insurers and providers.

With Vim Connect, our Privia Care Partners’ providers will gain a valuable resource that works within their existing EHR to surface gaps in care while reducing administrative burden and driving improved performance in value-based care operations across diverse practice environments. quote
Mark Foulke

EVP of Transformational Value-Based Care, Privia Health

Trusted by leading insurers and providers.

Trusted by leading insurers and providers.

We surveyed the market extensively, and Vim has outperformed by far in terms of ease of deployment, ability to scale, and most importantly provider experience. Vim moves our quality and risk adjustment operations out of spreadsheets and connects our data bidirectionally exactly where it needs to be - in the EHR interface during visit workflows. quote
Milan Vyas

Chief Value-Based Care Officer, MyCare Medical

Trusted by leading insurers and providers.

Trusted by leading providers

Vim’s platform has been a tremendous addition to our value based care delivery and growth strategy. By engaging our providers directly in their existing EHR workflows, Vim allows us to streamline our processes and save our clinical and operational teams time. This in turn improves our accuracy and allows our providers to focus on the most important part of their day, caring for our patients. quote
Dillon Moore

CIO at MaxHealth

Frequently asked questions

What are healthcare payer solutions?

Healthcare payer solutions refer to products, services, and technologies designed to support and optimize the operations of healthcare payers, such as insurance companies, government programs (like Medicare and Medicaid), and other organizations that finance healthcare services. 
These solutions typically aim to:
 
  1. Improve operational efficiency
  2. Reduce cost
  3. Enhance member experience
  4. Ensure regulatory compliance
  5. Manage risk effectively
  6. Streamline claims processing
  7. Facilitate data analytics and reporting
  8. Enhance stakeholder collaboration 
  9. Improve operations and workflows among stakeholders like health plans, providers and other vendors.

Why are healthcare payer solutions vital for my business?

Healthcare payer solutions - specifically payer technology- are critical for connecting disparate healthcare entities for improved operational efficiency and patient outcomes. Other vital components include: 
 
  • Interoperability: In healthtech, interoperability is crucial. Payer solutions that integrate seamlessly with other healthcare IT systems (like EHRs, telehealth platforms, and health information exchanges) can significantly improve data flow and care coordination.
  • AI and Machine Learning: Healthtech payer solutions often incorporate AI for tasks like predictive analytics, risk stratification, and personalized care recommendations. This can lead to more proactive health management and cost savings.
  • Telehealth integration: With the rise of telehealth, payer solutions that can handle virtual visit claims and integrate with telehealth platforms are becoming essential.
  • Real-time claims adjudication: Healthtech solutions can enable real-time claims processing, improving provider and patient satisfaction.
  • Digital member engagement: Modern healthtech payer solutions often include digital tools for member engagement, such as mobile apps for claims submission, appointment scheduling, and health tracking.
  • Value-based care support: Payer solutions that track quality metrics and outcomes are vital as the industry shifts towards value-based care models.
  • Data security and privacy: In healthtech, robust data security measures are crucial to protect sensitive health information and maintain HIPAA compliance.
  • APIs and developer ecosystems: Many healthtech payer solutions offer APIs, allowing for customization and integration with other innovative health technologies.
  • Population health management: Advanced analytics in healthtech payer solutions can support population health initiatives by identifying trends and high-risk groups.
  • Blockchain for claims and contracts: Some cutting-edge healthtech solutions are exploring blockchain for secure, transparent claims processing and smart contracts.

What are the advantages of healthcare payer administration software solutions?

Similar to the above, healthcare payer administration software solutions promote efficiency and collaboration with otherwise disparate entities in healthcare. Additionally, these solutions are often paid for by large health plans and distributed to providers to offer benefits such as:
 
  1. Faster reimbursements: Automated claims processing means providers get paid more quickly, improving ash flow.
  2. Reduced claim rejections: More accurate processing leads to fewer rejected claims, saving time and resources on resubmissions.
  3. Easier eligibility verification: Providers can quickly check patient eligibility and benefits, reducing the risk of providing unreimbursed services.
  4. Simplified billing: These systems often support electronic billing, making submitting claims and tracking their status easier.
  5. Improved communication: Many solutions offer secure messaging features, allowing providers to communicate directly with payers about claims or patient care.
  6. Transparency in claim status: Providers can easily track the status of submitted claims, reducing uncertainty and allowing for better financial planning.
  7. Streamlined credentialing: Provider credentialing processes are often simplified and accelerated through these systems.
  8. Better data access: Providers can access detailed information about claims history, helping them identify trends and areas for improvement in billing practices.
  9. Reduced administrative burden: With more automated processes, providers and care teams can spend less time on paperwork and more on patient care.
  10. Easier compliance: These systems often help ensure claims meet current regulatory requirements, reducing the risk of compliance issues.
  11. Support for value-based care: Many modern systems help track quality metrics, support provider participation in value-based care programs, and facilitate the transition from fee-for-service to value-based care.
  12. Integration with your systems: Advanced solutions often integrate with practice management and EHR systems, creating a more seamless workflow.

How can I select the ideal healthcare payer solutions for my business?

Selecting the ideal healthcare payer solutions for your business involves several key steps:
 
  1. Assess your needs:    - Identify your current pain points and inefficiencies    - Consider your future growth plans and scalability requirements    - Determine which features are must-haves vs. nice-to-haves
 
  1. Evaluate your budget:    - Consider both upfront costs and long-term total cost of ownership    - Factor in potential ROI from improved efficiency and reduced errors
 
  1. Research available options:    - Look at leading vendors in the market, such as Vim    - Read industry reports and reviews    - Attend healthcare IT conferences or webinars to learn about new solutions
 
  1. Check for interoperability:    - Ensure the solution can integrate with your existing systems    - Look for solutions with open APIs for future integrations
 
  1. Prioritize user-friendliness:    - Consider the learning curve for your staff    - Look for intuitive interfaces and good user experience design
 
  1. Verify compliance and security:    - Ensure the solution meets HIPAA and other relevant regulations    - Check for robust data security features
 
  1. Assess vendor support and reliability:    - Look into the vendor's track record and financial stability    - Check what kind of customer support and training they offer
 
  1. Consider customization options:    - Determine if the solution can be tailored to your specific workflows    - Check if customization requires additional costs
 
  1. Evaluate reporting and analytics capabilities:    - Ensure the solution provides the insights you need for decision-making
 
  1. Request demos and trials:     - Test the solution in your actual work environment if possible     - Get feedback from potential end-users on your team
 
  1. Check references:     - Speak to other businesses similar to yours who use the solution     - Ask about their experiences, challenges, and benefits
 
  1. Plan for implementation:     - Consider the time and resources needed for implementation     - Ensure the vendor offers adequate support during this process
Assessing a New Era of Payer Provider Partnerships

Watch our webinar to learn from experts as they share perspectives on an emerging new generation of approaches towards value-based care partnerships, the impact on the health care system in its journey towards value, and how technology is accelerating meaningful adoption.