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Vālenz® Unveils Solution to High Air Ambulance Costs

December 23, 2021/in Announcements, Featured, Press/by Maris Panjada

Valenz uses proven, proprietary repricing methodology to protect from surprise out-of-network billing

PHOENIX, Ariz. (December 23, 2021) — To help self-insured employers comply with requirements of the No Surprises Act (NSA) – and to protect plan members from sky-high surprise medical bills for out-of-network emergency air transport – Vālenz® has rolled out a new VMS™-validated solution within its ever-expanding ecosystem. The air ambulance solution creates a defensible qualified payment amount (QPA) for air ambulance services using Valenz’ proprietary repricing methodology. The result is fair pricing that assures a uniform level of protection for out-of-network air ambulance services.

“Recognizing that the January 1 requirements of NSA have a lot of employers chasing new solutions popping up in the market, we want Valenz clients to rest assured that the repricing methodology behind the Valenz air ambulance solution is completely tried and true,” said Rob Gelb, Chief Executive Officer. “In keeping with our long-standing commitment to transparency and balance billing protections, we are thrilled to apply our proven repricing methodology to combat runaway costs for emergency care, including air transport.”

The need is real – and dire. Over the last decade, the median billed charges for air ambulance services have doubled and even tripled (depending on the provider), with a staggering 71% of all air ambulance rides involving an out-of-network charge. As a result, the average cost for an air ambulance has soared to $50,000-$75,000 for helicopter and fixed wing transports, respectively.

By embedding its market-sensitive repricing methodology into air ambulance claim and cost review, Valenz is well ahead of the curve, said Gelb. “While others are working to develop new solutions, Valenz has always used this innovative repricing methodology to lower costs, enhance care and improve outcomes through quality-first care delivery – now we’ve just extended it to air ambulance. It’s all part of our promise to engage early and often for smarter, better, faster and more transparent healthcare.”

For more information about Valenz and how the Valenz ecosystem supports NSA compliance and balance billing protections, visit valenzhealth.com/nsa.

 

About Valenz

Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2021/12/Valenz_Air-Ambulance-600x432-1.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2021-12-23 21:52:162021-12-23 21:52:16Vālenz® Unveils Solution to High Air Ambulance Costs

Vālenz® Chief Operating Officer Amy Gasbarro Joins SIIA Board of Directors

December 17, 2021/in Announcements, Featured, Press/by Maris Panjada

PHOENIX, Ariz. (December 17, 2021) — Amy Gasbarro, Chief Operating Officer for Vālenz®, has been elected to the Board of Directors for the Self-Insurance Institute of America, Inc. (SIIA).

Gasbarro has worked with SIIA in various capacities since 2014, most recently as a trustee for Self-Insurance Political Action Committee (SIPAC), the advocacy and fundraising arm of SIIA. Her three-year term on the board will begin in January 2022.

“It is truly a privilege to become part of SIIA’s outstanding leadership group,” Gasbarro said. “The importance of self-insured health plans in the market is escalating, so this is a great opportunity to continue to advance self-insurance initiatives across the country. I am looking forward to making a strong impact on the SIIA board.”

SIIA works to protect and promote the business interests of companies involved in the self-insurance and captive insurance marketplace. As a single, member-based association, it is dedicated to meeting all the information, educational, networking and legislative/regulatory representation that a company needs.

“Amy has dedicated years of service to SIIA, and we are so proud to see her join the Board of Directors,” said Rob Gelb, Chief Executive Officer at Valenz. “It’s an honor for us as well to have one of our own guiding thought leadership within SIIA to support the evolving needs of the self-insured community and keep it strong, vigorous and healthy.”

 

About Valenz

Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2021/12/Valenz_Amy-G-SIIA-Annc_600x432.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2021-12-17 17:45:202021-12-17 17:45:20Vālenz® Chief Operating Officer Amy Gasbarro Joins SIIA Board of Directors

Vālenz® CEO: “Independent Dispute Resolutions Are Not Inevitable” Under No Surprises Act

December 10, 2021/in Announcements, Featured, Press/by Maris Panjada

Valenz repricing methodology mitigates risk of payment disputes

PHOENIX, Ariz. (December 10, 2021) — In response to “growing and unnecessary concern” about Independent Dispute Resolution (IDR) requirements that begin Jan. 1, 2022, under the No Surprises Act (NSA), leaders at Vālenz® are reaching out with assurance to clients that they already have proven tools to mitigate and even eliminate the need for IDRs.

Under the NSA, if there is a payment dispute from a provider, the health plan is required to participate in a third-party, unbiased arbitration process to establish a qualifying payment amount (QPA) for similar services in a geographic area. The health plan may need outside resources to fulfill claim settlement support for the IDR process, a stipulation that has created a rush of new IDR support solutions in market.

However, according to Rob Gelb, Valenz Chief Executive Officer, there is no need for Valenz clients to engage with new pop-up IDR solutions. For years, Valenz has used its proprietary VMS™ repricing methodology to circumvent payment disputes by ensuring fair, defensible, market-sensitive QPAs that both parties agree to. QPAs are based on years of real-world data from Valenz Access contracted networks, as well as additional layers of data from the broader Valenz ecosystem. Valenz has always negotiated with providers in the rare instances where they appeal a QPA. The IDR process only comes into play when an agreement isn’t reached through the normal appeal process and a provider decides to risk paying the cost of going to an independent arbiter.

“As a health data tech company with deep roots in member advocacy, our business model is built on a framework of clinical care management with a decades-long commitment to validation, integrity and accuracy (VIA). We’ve been delivering agile, data-driven solutions to pricing and reimbursement for years, always engaging early and often for smarter, better, faster healthcare,” said Gelb. “For us, this is not new at all – our repricing methodology is tried and true.”

Gelb advises all self-insured employers to embrace the power of transparency and data for improving the high costs of healthcare coverage today – and be cautious of solutions that don’t address root causes. “While others are fueling fear that IDRs will now be commonplace, we’re here to say the opposite – IDRs are not inevitable features of NSA compliance, not when you partner with Valenz.”

For more information about VMS™ visit valenzhealth.com/vms. To discuss how Valenz ensures fair and defensible pricing, call (866) 762-4455.

 

About Valenz

Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2021/12/Valenz_IDR-PR-600x432-2.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2021-12-10 23:04:102021-12-10 23:17:42Vālenz® CEO: “Independent Dispute Resolutions Are Not Inevitable” Under No Surprises Act

Vālenz® Renews Triple URAC Accreditation

December 3, 2021/in Announcements, Featured, Press, Valenz Care/by Maris Panjada

Continues legacy of excellence in clinical care combined with claim validity, integrity and accuracy  

PHOENIX, Ariz. (December 3, 2021) — Vālenz® is proud to announce the renewal of its three URAC accreditations in Health Utilization Management, Case Management and Disease Management. URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. By achieving this status, Valenz has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

“Because it underscores our staunch commitment to meeting rigorous standards in quality and accountability for clinical care management, we are very proud to renew our URAC accreditation,” said Janet Koch, RN, BSN, CCM, Vice President of Care Management at Valenz.

Rob Gelb, Chief Executive Officer, explains how clinical quality is integral to optimization within the entire claim-cost continuum – and pinpointing quality-first, cost-saving solutions for self-funded health plans requires the ability to see all intricacies and connections between clinical care and reimbursement.

“Valenz is unique in the way we combine clinical care management, advocacy and navigation for every member with assurance in the validity, integrity and accuracy of every claim,” said Rob Gelb, Chief Executive Officer. “Within the Valenz ecosystem, these two functions are inextricably linked – and fueled by data to ensure all claims are valid and true for accurate payments.”

That innovative and proprietary approach is foundational to the true value of the Valenz ecosystem and its ability to deliver the desired returns for Valenz clients. “Ensuring we consistently meet the high standards required for URAC accreditation is just one of many ways we keep our promise to engage early and often for smarter, better, faster healthcare,” said Gelb.

For more information about Valenz, visit valenzhealth.com.

 

About Valenz

Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

https://www.valenzhealth.com/wp-content/uploads/2021/12/Valenz_URAC-Renewal-PR-600x432-1.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2021-12-03 19:47:402021-12-03 19:47:40Vālenz® Renews Triple URAC Accreditation

Vālenz® Promotes Nathan Nelson to Chief Revenue Officer

December 3, 2021/in Announcements, Events, Featured/by Maris Panjada

PHOENIX, Ariz. (December 3, 2021) — Vālenz®, the innovators behind the industry’s most transparent, data-driven ecosystem for self-funded employers and their health plan partners, recently announced Nathan Nelson, MBA, has been promoted to Chief Revenue Officer.

Nelson, who joined the firm as Vice President of Business Development in April 2019, was promoted to the executive team when he was appointed Senior Vice President of Growth earlier this year. “Nathan’s rapid rise within our organization speaks volumes about the ways he embraces a client-centric focus in everything we do, from clinical and member advocacy to assuring the validity, integrity and accuracy of claims,” said Rob Gelb, Chief Executive Officer. “His commitment to the character, culture and vision that drive Valenz is laser-focused on keeping the client at the center of all decisions and propelling forward the power of the ecosystem for smarter, better, faster healthcare.”

Nelson brings 20+ years’ experience driving strong business growth across all areas of revenue – with proven success in sales and account management for the healthcare industry, primarily in the managed care segment. Prior to joining Valenz, he held sales and leadership positions in claim management, workers’ compensation, underwriting and account management.

“I am excited to lead our sales and client relationships forward,” Nelson said. “The opportunities for our clients are as limitless and groundbreaking as the Valenz vision. I look forward to expanding our clients’ success – and our own – in this new role.”

For more information about Valenz and its leadership team, visit valenzhealth.com.

 

About Valenz

Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2021/12/Valenz_Nathan-N-Annc_600x432-v2a.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2021-12-03 19:07:452021-12-03 19:07:45Vālenz® Promotes Nathan Nelson to Chief Revenue Officer

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