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Eligibility &
Enrollment

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Claims
Administration

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Payments
& Transactions

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Electronic
Documents

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Real-Time Chat
and Messaging

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Mobile &
Omnichannel

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Payment
Integrity

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Steering

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Workflow
Automation

What if technology could transform your business and improve health?

Viveka Health’s approach to benefits is distinctly unique. We do more than process transactions. We care about the health and wealth of you and your members.

We deliver administrative and clinical value to labor unions, third-party administers, carriers, and their members.

Our tools provide the intelligence to leverage data - from every available source - and translate it into actionable information that saves money and improves outcomes for every stakeholder across your health ecosystem.

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Eligibility & Enrollment

What if your enrollment and eligibility system learned about and cared for your people?

An individual’s health and wealth changes over the course of their lifetime. Life events and personal circumstances require easy mechanisms for restating benefits. Viveka understands the disruptive nature of managing ongoing changes.

Our consolidated eligibility and enrollment solution lets you collect and manage employee data, calculate benefits and, when life events occur, effortlessly restate benefits post incoming updates.

We make auditing easy for labor unions, TPAs, carriers, and government payers to manage upstream to members across all lines of business and export downstream to vendors and regulators. Audit to the benefit level using specialized computations, including hours worked, past year’s benefits, and payer contributions.

Integrate with our mobile app to ensure everyone receives real-time information and updates.

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Claims Administration

What if the real world informed how you processed claims?

Move beyond review, rinse, repeat claims processing cycles and embrace a completely new paradigm that shifts away from yesterday’s revenue cycle management (RCM) processing decisions towards tomorrow’s best practices engineered around the electronic medical record (EMR).

Our flexible claims processing solution stretches out and into the health ecosystem - to providers, payers, employers, and members - to gather intelligence in advance of a claim to minimize, mitigate, or manage up to the most accurate and efficient claim decisions.

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Payments & Transactions

What if you could automatically identify and reward your best people?

A dollar doesn’t go very far these days - but ways to shore up health payments are virtually limitless.

Whether adapting to new payment arrangements including fee for service (FFS), value- and risk-based, capitated, Per Member, Per Month (PMPM) or responding to new ways to move money (EFT, check, mobile, or debit accounts), our powerful payment solution lets you rapidly respond to how, who, when, and where payments need to occur.

Simplify, streamline, automate, and expedite even the most complex payments.

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Electronic Documents

What if one solution provided omnichannel correspondence?

Whether through email, SMS text, or postal mail, ensure you are sending the same message across all channels, so everyone is on the same page.

Our full suite of omnichannel communication solutions gives you the ability to exchange information in your stakeholder’s preferred medium.llect and manage employee data, calculate benefits and, when life events occur, effortlessly restate benefits post incoming updates.

Need to comply with regulations requiring print copy? No problem.

Need content translated to native languages? No hay problema!

Need to send the same message, at the same time, to every member via paper and digital tech? You got it! NO PROBLEM!

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Real-Time Chat & Messaging

What if you could engage stakeholders anytime anywhere?

“Alexa, has my surgery been pre-authorized?”

Healthcare costs continue to escalate with members increasingly sharing the burden.

With the stakes so high, consumers are engaging with their benefits as never before.

Incorporate Viveka’s intelligence into smart devices to help drive down costs and improve outcomes.

Our smart benefits platform lets you take full advantage of the connected devices diagnosing, monitoring, and managing health.

Reach out to members and providers proactively and replace surprises with solutions.

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Mobile & Omnichannel

What if your mobile app was your backoffice?

Mobile devices have replaced the desktop, the laptop, and tablets - they’re the first place people think to go when seeking answers.

Save time and money with Viveka’s mobile communications solutions. Our app lets you optimize the member’ benefits experience by providing answers, reducing postage and handling, and scheduling office visits.

Interface with your stakeholders anywhere, anytime in real-time through IM, SMS text, chat, tele, and AI endowed with real intelligence.

Leverage your distributed workforce and enable them to take care of business virtually anytime, anywhere through our mobile rich, mobile reach benefits management solutions.

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Payment Integrity

What if you could be sure health payments were legitimate?

Fraud, Waste and Abuse costs Americans more than $1 trillion dollars annually.

Whether intentional or unintentional, every day improper financial transactions occur as a result of inaccurate coding, bad information, delayed processes, and fraudulent activities - including security breaches.

We take the integrity of your payments seriously – constantly updating and validating databases, transactions, locations, and fact patterns to ensure claims are paid and reported correctly, completely, and accurately.

Integration with Viveka’s claims solution allows you to skip pay and chase by automating record requests and executing takebacks (credits) and other appropriate actions.

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Steering

What if you could house critical benefits data in one system?

Controlling costs means getting things right the first time, every time.

Viveka’s Intelligence Engine continually seeks, scrubs, validates, and enriches your data to make sure have the most up-to-date and accurate information to make the best decisions.

We interoperate with payer, provider, employer, and state and government databases to ensure you have real-time updates on stakeholder names, addresses, and other critical information.

Our innovative tools allow you to perform smart data analytics and produce rich reports and executive dashboards.

Quite simply, our smart technology automates the daunting task of aggregating, integrating, authenticating, organizing, and actualizing health information for health value.

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Workflow Automation

What if your team had more time in the day?

Stop paying multiple vendors for partial solutions, when one platform performs smarter, faster, and costs less to operate.

Viveka’s comprehensive and fully integrated solutions enable a cascade of business value.

Use our built-in intelligence engine to create optimal plan designs, define contribution levels, streamline communications, and automate processes.

Apply artificial intelligence, machine learning, and robotics automation technologies to save time and money, and free up your people to focus on more innovative initiatives.