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

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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.

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

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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.

Vālenz® Renews Triple URAC Accreditation

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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.

Vālenz® Promotes Nathan Nelson to Chief Revenue Officer

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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.

Vālenz® Unveils Solutions to Replace Traditional Reference-Based Pricing

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Innovative reimbursement strategies maximize plan dollars, improve provider relationships and drive significant savings

PHOENIX, Ariz. (November 19, 2021) — At a recent customer event, Vālenz® leaders unveiled a package of solutions that offer innovative alternatives to traditional reference-based pricing (RBP) agreements, designed to give self-insured employers more leverage in their local markets.

According to Rob Gelb, CEO of Valenz, the market needs to move away from traditional RBP approaches, which continue to be focused on basic payment reductions. “Now is the time to change the way you look at a reference-based approach to reimbursement that is defensible and allows customers to position in the market without contracts,” Gelb said. “The new Valenz package is designed to do this, plus it offers options to share risk with our customers.”

Each solution is fueled by data-driven insights and supported via the proprietary Valenz VMS™ Repricing Methodology yield fair, market-sensitive reimbursements that deliver improvement in savings as high as 75 percent, according to Gelb.

Valenz solutions offer options for self-insured employers to choose the path to smarter, better, faster healthcare that is best for their markets:

  • Access Open Solution maximizes plan dollars with a non-network reimbursement strategy that fosters equitable provider relationships. With integrated care navigation that lowers costs, this solution provides transparent quality and outcomes data for fair, defensible and consistent reimbursement recommendations.
  • Access Assured Payment builds on Access Open Solution to eliminate the risk of balance billing, member disruption and provider friction by offering assured payments for up to 91 percent of claim volume. The remaining claims undergo comprehensive, line-by-line bill review with provider sign-off for secured savings.
  • Access Amplified offers an out-of-network wrap solution – complete with care navigation, bill review and assured payment – to replace wrap networks. This solution directs members to high-quality care at fair, reasonable costs and secures appropriate, accurate charges for every out-of-network claim, resulting in significant savings.
  • Providing an alternative reimbursement approach for non-Medicare-based pricing – one that, like the other solutions, embeds VMS for fair, equitable, market-sensitive reimbursement rates.

“These solutions help maximize savings opportunities, reduce risk to the health plan, and put leverage back in the self-insured employer’s favor,” Gelb said. “That’s the power of the Valenz ecosystem. It lets us do what we do best, which is creating partnerships through contracts with providers.

“When we engage early and often to ensure active collaboration among the patient, providers and employer plans, we can ensure transparency and ultimately improve health outcomes.”

 

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.

Vālenz® Releases New Provider Locator for Members

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New search capabilities bring more transparency into access, cost and quality

PHOENIX, Ariz. (October 29, 2021) — In keeping with their commitment to innovation that fuels strong, vigorous and healthy lives, Vālenz® has announced the release its new Provider Locator tool. Available online for plan members and administrators to access anytime, the new and improved Provider Locator is uniquely designed to bring more information and transparency to the process of choosing a provider for healthcare services.

In addition to an array of filters for members to refine searches according to their individual needs and preferences, the new Provider Locator also includes star-ratings and cost data, as well as an interactive map that pins provider locations within the defined geography. Search results include providers currently under contract within each member’s Valenz Access provider network, as well as “Valenz-Friendly” providers who have previously accepted reimbursement from Valenz.

“Engaging early and often for smarter, better, faster healthcare can take many forms, but in most cases, it begins with connecting people to quality providers who will deliver the right care at the right time and at the right cost according to plan coverage,” said Maurice Steenland, Senior Vice President of Product and Delivery. “We are very excited about this initial release and look forward to continuously expanding the data available to plan members in support of their healthcare decisions.”

With future updates, says Steenland, the Provider Locator tool will become more robust with expanded cost and quality data for providers in Valenz networks.

 

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.

Vālenz® to Attend SIIA’s 2021 National Educational Conference & Expo

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Event to be held October 3-5 in Austin, Texas

PHOENIX, Ariz. (October 1, 2021) — As Diamond members of the Self-Insurance Institute of America (SIIA) and industry-leading innovators for the self-insured and captive insurance marketplace, Vālenz® leaders have announced they are attending SIIA’s annual National Educational Conference and Expo again this year.

The 41st annual conference event, which takes place virtually and in person, provides event participants with many opportunities to discover game-changing solutions, including the data-driven Valenz ecosystem.

“We are excited about this year’s conference theme – The Way Forward – because it reflects the need to reimagine the paradigms of self-funded health plans,” said Rob Gelb, Chief Executive Officer at Valenz. “That’s what we do every day within the Valenz ecosystem. We make it possible to achieve measurable, meaningful improvements in cost and quality year over year.”

Several members of the Valenz executive team will be attending this year’s SIIA conference, including Amy Gasbarro, Chief Operating Officer; Nathan Nelson, Senior Vice President, Growth; Jordan Hersh, Vice President, Business Development; Chris Shoffner, Vice President, Business Development; and Brittney Parrish, Senior Client Services Executive.

By integrating data from high-value provider networks, care management, revenue cycle, claim management and more, Valenz provides uniquely transparent and data-driven decision enablement. “Part of the way forward for our industry will be shaped by how we target the 5-15 percent of claims that drive up to 70 percent of health plan spending – that’s the key to driving costs down while driving quality and member experience up,” Gelb said.

The in-person component of the 2021 conference will be held at the JW Marriott Hotel in Austin, Texas. Educational content is being delivered virtually with a combination of live and pre-recorded sessions scheduled throughout the conference. Attendees are encouraged to talk with Valenz at the event for a one-on-one exploration of next-generation data engagement and decision enablement that drives smarter, better, faster healthcare.

 

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.

Vālenz® Hires Chris Shoffner as Vice President, Business Development

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Shoffner brings expertise and passion for improving health plan design

PHOENIX, Ariz. (October 1, 2021) — Vālenz® announced today the appointment of Chris Shoffner as Vice President, Business Development. With nearly 20 years’ experience as an advocate for re-imagining employee benefits to achieve better costs and outcomes, Shoffner’s expertise aligns well with the mission of the Valenz ecosystem.

“Chris is extremely knowledgeable and passionate about creating a world where employees and employers benefit from health plans that deliver better care at lower costs,” said Rob Gelb, Chief Executive Officer at Valenz. “His expertise and decades-long track record of pushing for positive change in health plans and the self-funded insurance industry align well with the culture here at Valenz, where every decision we make is designed to enable smarter, better, faster healthcare.”

Before joining Valenz, Shoffner held leadership roles in healthcare consulting and fiduciary services, where he honed his expertise in executive intelligence aimed at improving health plan design, risk management, population health and health literacy. His specialties include healthcare tax code, health plan design, disease management, risk management and strategic planning – “all the things health plan fiduciaries should be concerned about today,” Shoffner said.

In 2008, Shoffner was selected by North Carolina state legislators and the Commissioner of Insurance to serve on the 2008-2010 Blue Ribbon Task Force for the state’s health plan. That experience, combined with his extensive knowledge of health plan management and oversight, inspired him to run for the North Carolina House of Representatives in 2016, with his platform heavily focused on controlling healthcare costs.

“I’ve long been a proponent of using data to make good decisions, to indemnify patients from balance billing and protect health plan assets in ways that save money for payers as well as patients and providers,” said Shoffner, adding that it was this mutually shared philosophy that drew him to Valenz. “Within the Valenz ecosystem, transparent, data-driven decision enablement is already there, and it’s actionable – both from the top-down employer level and for ensuring plan members choose high-quality, lower-cost providers who will deliver the best care for them as individuals.”

Nathan Nelson, Senior Vice President of Growth at Valenz, says Shoffner embodies the innovative, can-do mindset that has made Valenz one of the fastest-growing private companies in the country. “We are very excited to welcome Chris aboard,” Nelson said. “I speak for the entire executive team when I say we have every confidence in him to move us even further forward in assuring everyone in our ecosystem is strong, vigorous and healthy.”

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.

Integrated Payor Solutions Seals Partnership with Vālenz®

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(September 30, 2021) – Integrated Payor Solutions, a full-stack tech solution for medical claim processing, announced a new partnership with Arizona-based healthcare company Vālenz®. “We’re proud to announce our partnership with Valenz, and excited to introduce our transparency solution for the No Surprises Act, Transparency+, into the powerful Valenz ecosystem,” said Shawn Evans, CEO of Integrated Payor Solutions. 

Transparency+ is a No Surprises Act-focused, bolt-on software solution offered by Integrated Payor Solutions that helps companies like Valenz provide their clients with more efficient and successful medical claims processing alternatives, including advanced EOBs. Additionally, this specialized solution by IPS is built on the flexible, dynamic Salesforce platform, which is easily integrated into any existing technology stack. “With the introduction of the No Surprises Act, we’re seeing companies like Valenz recognize how crucial the IPS platform is for their clients,” says Evans. “It’s rapidly becoming clear how critical it is for health plans to start implementing a transparency solution today – fortunately, we have the ability to bring that solution online in an average of 60 days.” 

“At Valenz, we are actively engaging with our health plan, TPA and self-insured clients to support them in implementing the federally mandated procedures for protecting patients from surprise medical bills and delivering increased transparency for medical costs and coverage,” said Rob Gelb, Chief Executive Officer of Valenz. “Together with ecosystem partners, like IPS, we are providing the foundation necessary for our clients to achieve compliance when the Act takes effect next year,” said Gelb. 

The No Surprises Act signed into law in December 2020 requires TPAs, health plans and self-insured employers to maintain up to date, in-network provider directories and disclose detailed pricing and cost-sharing information to consumers and other stakeholders. “These new requirements create a serious gap for health plans – one that IPS is equipped to solve with a stand-alone prospective claims processing system and cost estimator,” said Evans. “Our efficient implementation process brings health plans up to speed with transparency requirements, which is imperative as we approach 2022.” 

To learn more about Transparency+, visit www.IntegratedPayorSolutions.com or contact Shawn Evans today. 

 

About Integrated Payor Solutions 

Integrated Payor Solutions is the transformational cloud-based solution that powers your payor or network business. Because today, workflows can be paper-based and prone to errors, managed by antiquated software that takes forever to implement, or limited by costly in-house IT solutions. Learn more by visiting www.integratedpayorsolutions.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. 

Vālenz® Appoints Eric Hanna as Vice President, Claim and Access Solutions

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15-year veteran joins leadership team

PHOENIX, Ariz. (Sept. 27, 2021) — Vālenz®, the innovators behind a data-driven ecosystem of solutions that lower costs while improving quality and access for self-funded health plans, recently promoted Eric Hanna to the position of Vice President, Claim and Access Solutions. Eric brings 15 years’ leadership experience in implementation management and claims analysis at Valenz, as well as expertise in business, finance and client services.

“With his deep claims, data and implementation expertise, Eric keeps his eye trained on the goal of client success,” said Amy Gasbarro, Valenz Chief Operating Officer. “After 15 years with our firm, he has proven time and time again that he is always focused on the future of network strategy and innovative medical cost containment solutions for the self-insured employer.”

Eric brings leadership experience working with self-insured employers, third-party administrators and brokers in the areas of network strategy, claim management, employee benefits design and implementing technology solutions to streamline and accelerate claim operations. “I’ve long considered it an honor to be part of the Valenz team and having the opportunity to help our clients achieve greater levels of cost containment while improving the health outcomes of their members,” said Eric. “Today, I am proud to join the leadership team to accelerate ecosystem expansion for smarter, better, faster healthcare in the self-insured industry.”

Before his promotion to Vice President, Eric most recently served as Director of Networks and Implementation at Valenz. In 2019, Eric was selected for the prestigious Valenz Extended Leadership Team (ELT). He is a Certified Professional Coder (CPC) in claim coding and graduated Cum Laude with a bachelor’s degree in Business Administration and Management from Northern Arizona University.

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.

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