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FlexVP Managed Care Applications

ISG has created a series of IVR applications that can be selectively integrated to provide custom call handling solutions for health care organizations.


Referral Application

Our referral application gives a primary physician with a convenient automated method of referring a member to a specialist. 

In addition, the application can give providers with quick method to review and confirm previously entered referrals.

FlexVP accesses referral information through a data interface and this on-line data link assures that information provided to the caller is current. FlexVP then provides the caller with all matching referral information.

The referral application can be configured to include the following:

  • Referrals can be immediately entered into the MCO referral database
  • Referral codes such as ICD-9 and CPT can be included
  • Automatically generate referral case number or authorization number


Typically a referral (or authorization) application requests that a caller enter the following information: ID number of the referring physician, ID of specialist, diagnosis code, and the number of visits requested. Invalid referrals or diagnosis codes can be flagged and explained to the caller. When necessary, the caller can be transferred to a service representative to handle non-standard or problem referrals.



Voice Response Overview

FlexVP IVR Platform

FlexVP allows callers to automatically access healthcare and member information using a touch-tone telephone. Applications include verification of member eligibility, obtaining member benefits information, accessing status of claims information, and authorizations / referral entry and review.

This information is obtained through an interface to the managed care organization's claim system. ISG has integrated the FlexVP interactive voice response (IVR) system with healthcare claims systems offered by: DST Health Solutions, Perot Systems, Erisco Facets, Ika Systems, and OAO Healthcare.

FlexVP can access network or LAN databases including Microsoft SQL, Oracle, MySQL, etc. using a data view, stored procedure or web service.

For legacy products,  FlexVP can connect to mini or mainframe computer using 5250, 3270, VT100 or other terminal emulation.


FlexVP Benefits

  • Information available 24 hours a day, 7 days a week
  • Faster service to providers and members
  • Decreased wait times and abandonment rates
  • Increase call capacity without adding service reps
  • Customer defined levels of login and password security
  • On-line, real-time system status checks and reporting
  • Provide consistent information to insure HIPAA compliance
 

2009 Insurance Systems Group, Inc. P.O. Box 50387 Raleigh, NC 27650