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Provider Villa
Provider Villa
Provider Villa is a comprehensive solution that caters to provider integration needs of health plans and their operational processes. It is a central repository of provider and facility data which can be shared according to needs of different processes.
Why our Provider Villa solution is preferred by Health Plans
Single source of truth
Single source of truth for provider related information
Real time integration
Solves routine needs through real time accurate information from dependent systems
Provider self-registration
Providers can self-register into the application with valid TIN and NPI combinations
User account administration
Admins can easily manage user accounts in the Provider Portal
Reports for insights
Standard and Adhoc reports for audit purposes and insights
Why our Provider Villa solution is preferred by Health Plans
Single source of truth
Single source of truth for provider related information
Real time integration
Solves routine needs through real time accurate information from dependent systems
Provider self-registration
Providers can self-register into the application with valid TIN and NPI combinations
User account administration
Admins can easily manage user accounts in the Provider Portal
Reports for insights
Standard and Adhoc reports for audit purposes and insights
Features at a glance
Add Vendor with 1099, Pay-to address details, notes, contacts, attaching supporting documents, adverse actions etc
Add Contract for “In network” providers at office location & for a time period. Creation of contract with Payclass, CPT and rev code-based exceptions for claims processing. Ability to capture interest rates, time limit for recoupment
User can add multiple contracts and each contract information should be unique on the basis of below combinations:
Mandatory : TAXONOMY+NPI + TAXID+PAR or NONPAR
Optional : IPA+ PRACTICE LOCATIONS
Add Provider details with address validations through smarty street, NPI validations with NPI registry, degree, provider type (PCP/ specialist/Mid Level Practitioner), location details with dates, linking of contract with providers and vendors, alias information
Generation of unique Plan Provider ID if missing in migration
Send the daily report to users after migration (for auditing)
Add facility (hospital) details with tax id being common ID across multiple NPI’s
Capture basic details of non-par providers but without contracts
Search Provider on criteria like First Name, Last Name, NPI, Tax ID, Provider ID, PlanProviderID, Provider Type, Contract Status
Search Contract on basis of Contract ID, Contract Name and Pay To
Search vendor on basis of Tax ID/SSN, ID, Legal Name, Address, Pay to ID, Pay to Name, Payment System status
Load Vendors File for bulk vendor & Pay-to creation
Approval Queues for approving uploaded 1099/ Pay to Address
File Tracker to keep track of files uploaded
API’s to provide information to following systems:
○Enrollment system for mapping members to PCP
○Claims Adjudication system for claims processing
○Utilization Management system for creating Pre auth for members
○Customer service management / Provider portal
Manage roles, users and mapping of users to role
Standard and Adhoc reports for audit purposes and insights
Search degree from list of created degrees
Download BrochureWhy choose MIRRA's® Provider Villa Solution?
Mirra’s Provider Villa is designed as one-stop solution to provide access to providers for member’s benefits, eligibility, claim and payment status as well as prior authorization information. Self-service capabilities improves the efficiencies and satisfaction for providers, lowers the inquiries into the member services team, and increases the timeliness for authorizations, referrals, and appeals processing.
Reviews & Testimonials
Mirra collaborated well with our operations and compliance teams to successfully design and implement a system that was innovative, efficient, and compliant with all Medicare and Florida Medicaid guidelines and requirements all within the scope of our required timeline.
We greatly benefitted from the Mirra Project Management Team’s regular communication with Stakeholders through monthly meetings and recurring weekly breakout-focused calls, which were geared towards troubleshooting and goal alignment. Mirra was able to quickly maneuver and adapt their systems to our needs, resulting in successful implementation and go-live. Mirra continues to support our compliant operation and growth in the ever-changing healthcare industry rapidly and effectively updating their systems with new Medicare and Florida Medicaid rates and guidelines to ensure seamless compliance and efficiency. I have absolutely no reservation in recommending their systems to any Payer searching for improvement in their operational efficiency."
NANCY GAREAUCEO of Ultimate Health Plans
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