Data management and file processing are key components of Ocular Benefits’ vision benefit management, and we ensure accuracy and efficiency through our use of state-of-the-art technology. With the Enterprise System, we’re able to process and manage all types of data, including provider data, flexible reimbursement methods and member eligibility. Our comprehensive data management is tailored to each client’s specific business requirements, proprietary file formats, and customized reporting formats and schedules. We collect and process data all in one place, giving clients instant access to the information they need for strategic business management.
Eligibility & Enrollment Data Management
With the Enterprise System, Ocular Benefits can accurately and efficiently verify member eligibility and enrollment for vision benefits. Eligibility is based on plan design, date of service, member and dependent enrollment information and business rules as defined by each client. Enrollment data management is also tailored to our clients’ business requirements. Ocular Benefits is able to make plan-wide updates to eligibility and enrollment data, saving our clients time and administrative effort. Clients can access real-time eligibility and enrollment reports at any time through the web-based Client Portal.
Encounter Data Management
Ocular Benefits leverages years of experience and state-of-the-art technology to help clients remain in compliance through accurate, timely and thorough encounter data reporting on government programs. We are experienced in designing and delivering encounter data extracts and detailed reports in a variety of formats that meet state and federal requirements. We can also re-package any data in the Enterprise System into client-defined reports with no programming change required. At any time, clients can view real-time reports on the status of their encounter data.
Provider Data Management
As part of our central focus on lowering cost, Ocular Benefits streamlines provider data management to reduce administrative burden. We capture and manage all provider data online, including locations, fee and reimbursement schedules, contracts and credentialing. Our capabilities with the Enterprise System improve data quality and allow for rules-bases automation and network-wide updates. Ocular Benefits’ paperless environment also facilitates communication with providers and provides greater network transparency for our clients.
Ocular Benefits features flexible reporting that can be easily customized to meet clients’ specific requirements for data, layout and file format and uploaded to a secure file transfer protocol (SFTP). We draw on years of experience in delivering HIPAA-compliant state and client-specific reports weekly, monthly, quarterly and annually. In addition, hundreds of standard reports, many of which are customizable through the user interface, are available on demand for immediate online access. Reports display real-time data drawn directly from Enterprise System databases, and most can be exported in a variety of file formats, including PDF and Excel.