Through a longstanding partnership, Valenz engaged early and often through its Case Management solution to guide members to smarter care choices, ultimately delivering more than $715,000 in savings and a total 2.3:1 return on investment for a TPA group.

A large healthcare plan payer partnered with Valenz to conduct a comprehensive review of more than 626,000 medical claims incurred over six months to capture potential savings from billing inaccuracies, coding errors, and clinical discrepancies. Using its Clean Claim Verification solution, the Valenz team identified potential savings of $112.6 million in initial billed charges, reduced to $43.4 million in allowed charges.

A regional health plan with approximately 130,000 covered lives recently partnered with Valenz to address a high-cost air ambulance claim. By leveraging the Air Ambulance solution, a feature of Valenz Out-of-Network Repricing, the team reduced the initial provider offer for a combined savings of $20,000.

With healthcare costs soaring, an employer in the Southeast needed a solution to empower employees to make smarter, more cost-effective care decisions — supporting cost-containment and strong, vigorous, healthy lives for all. The employer partnered with Valenz to implement a shared savings model and engagement strategy that drove higher utilization, better care outcomes, and $239,000 in total savings.

A large insurance and investment company insuring nearly three million union members and their dependents partnered with Valenz to conduct a line-item bill review on a high-cost claim and to engage in provider collaboration, resulting in 57% in savings above the PPO allowable.

With a large hourly workforce, Bashas’ was constantly looking for creative ways to control medical spend without shifting too much of the financial burden to employees. Bashas’ implemented Valenz Bluebook to educate employees on in-network price variances, enabling them to make educated and value-based healthcare decisions

To help rein in spending and maintain a workplace culture that treats everyone like family, Alex Lee focused on shared accountability: incentivizing employees to choose high-value care and save money for everyone. By building a trusted partnership with Valenz Bluebook, Alex Lee empowered employees to shop for high-value healthcare, resulting in a 146% increase in savings.

Through strategic pre-negotiation, Valenz collaborated across broker, carrier, employer group, provider, and third-party administrator (TPA) to achieve expeditious care and savings of more than $900,000 for a member requiring complex surgery.

By integrating the full continuum of self-funding solutions on the Valenz platform, schools within a consortium in Missouri generated greater savings from robust front-end care navigation and cost-containment solutions, reducing premium increases and improving the member experience.

See how our Clinical Bill Review solution created second-pass additional savings of $120M ($40,000 average per claim) by supplementing the payment integrity program of a large multi-state health plan.