Case Study: Virginia Premier Health Plan, Inc. achieves HIPAA‑compliant eligibility, on‑demand provider rosters and a secure employer portal with HealthEC

Virginia Premier Health Plan, Inc. - Customer Case Study

Virginia Premier Health Plan, Inc. engaged HealthEC to meet new state requirements for HIPAA‑compliant eligibility transactions, electronic panel listings for its PCP network, and a scaled corporate web presence with a secure employer portal and provider/hospital search. The HMO needed a solution that would integrate with legacy enrollment and adjudication systems while complying with state marketing restrictions and supporting more than 110,000 members.

HealthEC delivered a custom implementation of the HealthEC Solution Provider Portal, Employer Portal and Provider Search Engine (formerly IGI’s Orbit), a Java‑based, load‑balanced application with an Oracle backend. The portal provides real‑time eligibility and benefits inquiry, self‑enrollment for providers, on‑demand panel listings that eliminate costly print mail and out‑of‑date rosters, an NPI registry, and automated daily updates of member and provider files. By hosting and managing the system, HealthEC removed the need for Virginia Premier to staff manual enrollment, improved data timeliness, and replicated the service for its sister plan, Virginia Coordinated Care.

Virginia Premier Health Plan, Inc.