SKYGEN USA Companies



To reduce the cost and risks of health benefit delivery for healthcare payers, managed care organizations, and delivery systems.

Scion Dental


State & Federal

State & Federal Agencies

Leverage our experience to keep costs low and increase your insight through greater transparency.

Managed Care Organizations

Managed Care Organizations

Our experience will help you effectively manage increasing volumes of new members. 

Commercial Payers

Commercial Payers

Helping you bring new products to market faster, and keeping them reform-ready.

Hospitals & Healthcare Systems

Hospitals & Health Systems

Gain control with our years of experience in non-traditional reimbursement.

Accountable Care Organizations

Accountable Care Organizations

Manage your risk and your reimbursement more effectively.

  • "I view Vestica Healthcare as a member of our team and part of our company."
  • "Vestica Healthcare captured billing errors that saved our facility over $400,000 or more during the first year.” 
  • "From Day 1, the Vestica Healthcare team has been key to what I consider a great relationship."
  • "The relationships that my team and I have grown with Vestica Healthcare have just been fantastic."
  • "Vestica Healthcare’s customer service has been very good."
  • "People and technology are Vestica Healthcare’s top strengths."

Frequently Asked Questions

To help you find the information you need quickly, we've collected answers to some of the most frequently asked questions about Vestica Healthcare.  Click on a question to have the answer drop down below.

Does Vestica Healthcare offer bundled payment options?

Yes! We have the flexibility and innovative technology to integrate with payer systems, and will present individual payers with bundled payment claims that comply with their requirements. Our bundled payment specialists have experience with severity adjustments, administration of similar bundles with different elements or pricing, and other highly specialized methodologies. Over the years, we’ve developed a successful track record for accurate, timely collections from payers and efficient, proper distribution of provider payments.

How are you handling the transition to ICD-10?

Our ICD-10 readiness was part of our 2013 design and software development efforts. We will support both ICD-9 and ICD-10 Diagnosis and Procedure codes for some period of time prior after the October 2015 mandated effective date.

How does Vestica Healthcare achieve an auto-adjudication rate of nearly 99%?

Our unique, rules-based approach to claims processing takes traditional data challenges out of play with an integrated system architecture and by building customized packages of business rules that automatically pay claims accurately and on time. To ensure accurate adjudication and payment, claims data is automatically cross-referenced and fully integrated with member enrollment/eligibility data, benefit plans, providers and locations, and reimbursement rules. Data is shared and available throughout the integrated system for real-time online access.

Do you offer EPSDT and HEDIS reporting?

Yes, our staff has extensive experience developing customized outreach plans and generating metrics that monitor the effectiveness of each outreach tactic. Because each client has different business objectives, and because each outreach option has its own benefits, Vestica Healthcare works with each client to develop a multi-pronged approach that meets the needs of the client’s membership. Reporting includes annual, semi-annual and High/Low Productivity performance.

How have you streamlined patient eligibility verification?

To simplify this cumbersome task, we developed an innovative patient scheduling tool. Providers can replace the need to make a time consuming phone call to verify eligibility for each scheduled patient with an online, single-step process for the complete daily patient roster. Providers can then save the eligibility verified roster for retrieval on the date of service. When the patient visit occurs, they can click the patient’s name and a completed claim form is created—missing only the diagnosis and procedure codes.

Can you really create a paperless process?

Yes. The Enterprise System, developed by our sister company Wonderbox Technologies, is designed to support paperless workflows through web-based architecture, built-in document management system, and fully integrated self-service web portals. Our paperless environment is one of the fundamental ways we maintain low administrative costs.

Related Services

Our sister companies lead their specialty markets with solutions which reduce costs and improve the way health benefits are administered.

Vestica Healthcare, LLC

W140 N8981 Lilly Rd.
Menomonee Falls, WI 53051
Phone: 800.370.2720

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