Virtual Incident Manager (VIM) 

Fully Configurable Technology Allowing Plans To Effectively Document, Manage, and Report On Every Event. 
Once Virtual Incident Manager is implemented, Plans will find it easier to proactively identify trends, close operational performance gaps and monitor all of their compliance-related events, regardless of the line of business, all as they happen
in real time. 

BEST CASE USES FOR VIM:

  • Conflicts of Interests

  • Employee Misconduct

  • Targeted Training

  • Gift Tracking

  • HIPAA & HITECH Breach Investigations

  • Sales & Marketing Events

  • Special Investigations

* Produces CMS Universes and Pre-Audit Issues Summary

  • Audits (scheduled and ad-hoc)*

  • Monitoring Efforts*

  • FDR Oversight & Attestations*

  • Fraud, Waste & Abuse Investigations*

  • Non-Compliance Events*

  • Corrective Action Plans*

  • Beneficiary Impact Analysis*


KEY BENEFITS

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  • All the tools you need to track and search events without spreadsheets.

  • The ability to capture, document and follow incidents impacting your organization:

              • Training and Education

              • Vendor/FDR Oversight

              • Special Investigations

              • Fraud, Waste and Abuse Cases

              • Marketing and Agent Oversights

  • Fully configurable workflows specific to the event & your way of working.

  • Reduce organizational compliance risk by setting alerts and flags of important events.

  • Ensures all steps on specific incidents are followed prior to resolution.

  • Ability to add your health plan’s correspondence and automatically produce letters.

  • Incidents and type of issues are tracked for easy reporting to CMS and Board of Trustees without IT support or data requests within the Reporting Module.

  • Used for cases like HIPAA, Hi-tech, and many other Audit Workflows.

  • Leads to improved STAR ratings, reduced number of NONC’s (Notice of Non-Compliance) and
    minimize CMPs (Civil Monetary Penalties).


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DOCUMENT ROOT CAUSES WITH VIM

  • Complete Compliance Tracers In Advance Of A CMS Audit

  • Identify CMS-Required Self-Disclosure Risk Areas

  • Produce CPE Audit Universes At The Touch Of A Button

Table 1 – First TIER Entity Auditing and Monitoring

Table 3 – Internal Auditing

Table 4 – Internal Monitoring

Table 5 – Fraud, Waste and Abuse Monitoring