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Vālenz® Announces Partnership with Beecher Carlson

July 12, 2021/in Announcements, Featured, Press/by Maris Panjada

Risk Bearing Provider Organization Assessment Can Help Minimize Risk, Drive Savings for Value-Based Care

PHOENIX, Ariz. (July 12, 2021) — Vālenz® has announced a strategic partnership with Beecher Carlson, an insurance brokerage firm that leverages advanced analytics for optimal risk management. Through this partnership, Valenz and Beecher Carlson collaboratively offer the industry’s most in-depth Risk Bearing Provider Organization (RBPO) Assessment for thorough, data-driven analysis of whether an organization is positioned successfully for two-sided risk contracts in a value-based payment model.

Value-based payment models offer significant opportunities to reduce costs, enhance quality and improve outcomes. However, the pay-for-performance reimbursement structure might not be right for every health system or provider group. This RBPO Assessment identifies areas that need assistance and offers solutions to address potential deficiencies. It also helps determine if the program goals and incentives are aligned with the organization’s expected results and endorsed by all stakeholders.

“While there is a high level of interest and enthusiasm for value-based care, the clinical and financial risks need to be carefully considered – and in a two-sided contract, cultural and operational requirements must be in place to ensure success,” said Rob Gelb, Chief Executive Officer of Valenz. “Through this partnership with Beecher Carlson, we are excited to provide actionable insights and proven solutions to guide our clients’ approach to value-based care.”

As noted by Brad Lawson, Senior Vice President-Provider Risk Solutions of Beecher Carlson, the RBPO Assessment financial models assess risk-reward ratios, quantifying maximum probable gains as well as the maximum probable losses. “The 360-degree data and trend analyses account for real-world conditions, allowing organizations to stay nimble, proactively manage risk, and prepare for developing situations – such as an influx of more serious cases following the COVID-19 pandemic as a result of delayed care,” he said.

 

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. Valenz is backed by Great Point Partners.

 

About Beecher Carlson

Beecher Carlson is a large account risk management broker that values depth of industry and product knowledge. Operating as a single profit center organized by specialization, we align our service teams to be structured based on what is best for clients’ business rather than geographic convenience. We go beyond one-off transactions and utilize advanced analytics on every program. By quantifying the effects each decision will have on a company’s risk profile, we take the mystery out of buying insurance. Execution on analytical findings is our true differentiator in mitigating losses and affecting process changes. Our collective success is earned by creating the ideal risk management solution for our clients. To learn more, visit beechercarlson.com.

https://www.valenzhealth.com/wp-content/uploads/2021/07/Valenz-Beecher-Annc_Blog-600x432-1.jpg 432 600 Maris Panjada http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png Maris Panjada2021-07-12 21:30:352021-07-12 21:30:35Vālenz® Announces Partnership with Beecher Carlson
Vālenz® Announces Strategic Partnership with Turquoise Health

Vālenz Announces Strategic Partnership with Turquoise Health

April 26, 2021/in Announcements, Featured, Press, Valenz Access/by Maris Panjada

Database of negotiated hospital rates elevates consumer transparency and choice

PHOENIX, Ariz. (April 26, 2021) — Vālenz® announced today a partnership with Turquoise Health, a software solutions company that facilitates consumer transparency through its newly launched platform listing payer-negotiated hospital rates.

With new price transparency regulations requiring hospitals to share previously undisclosed rates for many services, Turquoise Health has created the first comparison engine for consumers to make cost-effective decisions about their care.

With full access to Turquoise Health’s database of hospital rates, Valenz will incorporate the comparison information into its concierge-level navigation program and self-service member portal. Valenz also will utilize the data to build highly efficient networks that drive quality care and customer satisfaction alongside cost savings.

“Our partnership with Turquoise Health aligns with our data-driven ecosystem and helps us take a significant step toward providing the transparency our clients and their members need,” said Rob Gelb, CEO of Valenz. “Not only can we share the cost structure of hospital services to help guide members’ decisions, but we can also help them gauge the quality of the service. It’s a key component of the Valenz promise to assure smarter, better, faster healthcare.”

As of Jan. 1, 2021, the federal rule requires hospitals to publish a machine-readable file listing their negotiated payment rates for hundreds of medical procedures, as well as a website where consumers can search for services and prices. Initial compliance has been mixed, with reports of some hospitals blocking their pricing from showing up on web searches – making the Turquoise Health platform all the more valuable in elevating transparency.

CEO Chris Severn says its database currently has more than 2,000 verified rates, and the list continues to grow as Turquoise painstakingly combs through and verifies hospital pricing data.

“This is just the beginning of making hospital billing more clear and patient-friendly,” Severn said. “Using both public price rates data and Turquoise participating provider data, we are showing there is a market for transparency in healthcare. We help put negotiating power where it belongs — in the hands of the consumer.”

 

About Valenz

Vālenz® 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 connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

 

About Turquoise Health

Turquoise Health launched in 2020 with a vision to simplify healthcare reimbursement through price transparency. CTO Adam Geitgey, formerly a Director of Engineering at Groupon, brings deep consumer marketplace experience to the healthcare sector. Turquoise invites providers and payers to become Turquoise Verified partners. Using the software suite, organizations create “price certainty” for patients while easing claims adjudication on the back end. Turquoise already counts major revenue cycle partners and hospital systems as satisfied clients. To learn more, visit turquoise.health or email info@turquoise.health.

https://www.valenzhealth.com/wp-content/uploads/2021/04/Valenz_Turquoise-Annc-601x433-1.jpg 433 601 Maris Panjada http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png Maris Panjada2021-04-26 17:19:492021-04-26 17:19:49Vālenz Announces Strategic Partnership with Turquoise Health

Vālenz™ NaVcare Delivers Data-Driven Care Navigation, Improves Network Utilization, Member Satisfaction and Health Outcomes

September 25, 2020/in Announcements, Featured, Press, Valenz Care/by ryan kesner

PHOENIX, Ariz. (Sept. 25, 2020) – As part of its triple-URAC-accredited Vālenz Care suite, Valenz has announced the launch of NaVcare, a concierge-level care navigation program that combines data with service delivery to improve utilization, member satisfaction and health outcomes. Based on intelligence from multiple sources within the Valenz ecosystem – including claim, pharmaceutical and demographic data – NaVcare is tailored to each employer with personalized services for each health plan member.

“We place the patient at the center of care, starting with high-touch member onboarding to empower individuals in making better healthcare decisions, improving outcomes and enhancing their experience,” said Amy Gasbarro, Chief Operating Officer. “Working one-on-one with plan members, our care navigators provide expert knowledge of the health plan, care plan and provider network to guide members toward high-quality, low-cost care and medication.”

NaVcare brings member-centric services and data-driven insights into the patient journey, connecting the dots for smarter, better, faster healthcare. NaVcare navigators serve as a central hub for care coordination, providing personalized education, collaboration and communication.

“When integrated with the full Valenz ecosystem, real-time intelligence allows us to target the 5-15 percent of claims that drive 70 percent of an employer’s health spend,” explained Rob Gelb, Chief Executive Officer. “By integrating the high value network design of Vālenz Access with care navigation, Valenz is helping our clients achieve up to 85 percent in-network participation within 12 months, resulting in significant plan and member savings.”

For more information, call (602) 792-5371.

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. Learn more at www.gppfunds.com.

https://www.valenzhealth.com/wp-content/uploads/2020/09/Valenz_NavCare-web.jpg 433 601 ryan kesner http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png ryan kesner2020-09-25 21:23:182020-09-25 21:23:18Vālenz™ NaVcare Delivers Data-Driven Care Navigation, Improves Network Utilization, Member Satisfaction and Health Outcomes

V3 Repricing Engine: Fueled by Big Data to Ensure Fair, Market-Supported Reimbursements

September 14, 2020/in Announcements, Featured, Press, Valenz Claim/by kamryn cain

PHOENIX, Ariz. (Sept. 14, 2020) – To accelerate fair and accurate claim repricing and ensure market-supported reimbursements, Vālenz™ has introduced the V3 Repricing Engine. Fueled by the volume, variety and velocity of data within the Valenz ecosystem, V3 supports strategic decision-making and creates value for the payer, the provider and the patient.

The V3 Repricing Engine can identify patterns and pinpoint high-performing providers with optimal cost structures, along with delivering greater efficiency and reduced turnaround times for processing and payments. Ultimately, it ensures savings on professional claims, which account for up to 85% of claim volume for self-funded insurers.

Aggregating years of robust claims data with industry-leading sources, the V3 Repricing Engine uses the proprietary, data-rich VMSSM Repricing Methodology to determine fair, defensible claim reimbursements. Its detailed analysis goes further to identify potential program pain points and opportunities for additional savings. For integrity and timeliness, VMSSM continuously scrubs and adjusts the data as needed to ensure a fair market price for all services rendered, while identifying potential fraud, waste and abuse.

“As we continue to identify solutions that control costs while serving the member and helping the employer, the V3 Repricing Engine is one more way we fulfill our promise of better, smarter, faster healthcare,” said Rob Gelb, Chief Executive Officer of Valenz. “The proprietary algorithms of our VMSSM Repricing Methodology provide actionable insights to support a consistent and substantiated reimbursement model, reducing friction among the payer, provider and patient.”

Curating from multiple data sets to offer up-to-date, regionally specific reimbursement recommendations, the V3 Repricing Engine is fueled by the three Vs of big data:

  • Volume: Years of historical paid claims data
  • Variety: Numerous geographical, medical and claim data elements
  • Velocity: Up-to-date information using real-time insight

“While the V3 Repricing Engine applies to all medical claims, it maximizes discounts for high-volume, low-dollar claims – an overlooked segment in the market to increase value for self-funded plans,” said Amy Gasbarro, Chief Operating Officer of Valenz. “This approach to repricing reduces the cost of healthcare for all parties involved.”

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. Learn more at www.gppfunds.com.

https://www.valenzhealth.com/wp-content/uploads/2020/09/shutterstock_347798435-2.png 433 601 kamryn cain http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png kamryn cain2020-09-14 21:28:212020-09-14 21:28:21V3 Repricing Engine: Fueled by Big Data to Ensure Fair, Market-Supported Reimbursements

United Claim Solutions Becomes Vālenz

September 30, 2019/in Featured, Press/by ryan kesner

The UCS Family of Companies now operates under unified corporate name, delivers complete health administrative ecosystem

The United Claim Solutions Family of Companies – one of the nation’s leading medical cost reduction and claims flow management organizations serving the self-insured employer community directly and with partners in the benefit consultant, broker and payer communities – today announced the transformation of the organization through its new name: Vālenz™.  The new name unites a suite of solutions and completes the integration of all of the resources necessary to deliver the industry’s first complete healthcare administrative ecosystem.

“Valenz is a fully integrated, single-source, end-to-end platform that connects and analyzes cost and quality data to reduce the total cost of care while improving health outcomes,” said Rob Gelb, Chief Revenue Officer. “As data flow through the Valenz ecosystem, our analytic and predictive capabilities enable us to engage early and often for smarter, better, faster healthcare.”

Actionable data is key. The firm has spent years and invested in key resources building integrated data systems and fine-tuning solutions that support its client base of self-insured employers, third-party claim administrators, brokers and benefit consultants, labor and trust organizations, stop-loss carriers, integrated healthcare delivery networks, and health/dental plan payers.

Founded in 2004 as United Claim Solutions with a vision of creating comprehensive and innovative solutions to support the self-insured industry, over nearly two decades, the company has steadily expanded its development and use of analytics that drive new solutions and reset the expectations of a service partner.

In 2015, the company launched a division dedicated solely to filling the void in access to high-value medical networks and creating alignment between the payer, patient, employer, medical professional and health system. Two years later, they acquired and integrated a suite of care management offerings, followed quickly by another acquisition that brought software-based tools for payment integrity and compliance into the evolving health administrative ecosystem.

Today, the Valenz ecosystem comprises these services – powered by data from payers, employers, patients and health systems – to provide a highly innovative solution. Available as standalone products and as an integrated platform, the Valenz ecosystem includes Vālenz Care (formerly INETICO); Vālenz Access (formerly NX Health Network); Vālenz Claim (formerly United Claim Solutions); and Vālenz Assurance (formerly Zebu Compliance Solutions).

“As healthcare costs continue to rise, affecting the plan costs of employers and the out-of-pocket expenses of members, we are taking a fully integrated, data-driven approach that substantially impacts total medical spend in key areas,” said Gelb. “This complete ecosystem brings our clients superior cost savings and outcomes than they can achieve elsewhere by focusing action on the claims that drive these costs.”

 

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Serving self-insured employers, third-party claim administrators, brokers and benefit consultants, trust and labor organizations, stop-loss carriers, integrated healthcare delivery networks, and health/dental plan payers, Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. Valenz is backed by Great Point Partners. 

 

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading health care investment firm, currently with approximately $1.8 billion of equity capital currently under management and 28 professionals, investing in the United States, Canada, and Western Europe. GPP is currently making new private equity investments from GPP III. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III which has $306 million in committed capital) and public (BioMedical Value Fund family, approximately $1.1 billion) equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 100 growing health care companies. The private equity funds invest across all sectors of the health care industry with particular emphasis on biopharmaceutical services and supplies, outsourcing and alternate site care, pharmaceutical infrastructure and information technology enabled businesses. The firm pursues a proactive and proprietary approach to sourcing investments and tuck-in acquisitions for its portfolio companies. Reach Great Point at 203-971-3300 or www.gppfunds.com.

https://www.valenzhealth.com/wp-content/uploads/2019/09/Runners-Blog-Image.png 432 600 ryan kesner http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png ryan kesner2019-09-30 09:00:142019-10-16 16:12:34United Claim Solutions Becomes Vālenz

The UCS Family of Companies Welcomes a New Executive Growth Leader

January 14, 2019/in Press/by ryan kesner

The United Claim Solutions (UCS) Family of Companies is pleased to announce and welcome Rob
Gelb as the company’s new Chief Revenue Officer. Rob will be responsible for all aspects of revenue
growth for the enterprise which will include direct oversight of all business development functions and
engaging related operational, product and financial resources that serve the needs of hundreds of
valued clients every day. Gelb will seek to build on the historical success of the company and will
focus on business development that will drive client expansion and position the UCS Family of
Companies for transformational business growth. He is an accomplished leader with a consistent
record of strategic and tactical success in organizing, operating, managing and expanding profitable
businesses.

“With over 20 years in expansive leadership roles including Senior Vice President of Strategic Sales
at Coventry Workers’ Comp Services, Managing Vice President at York Risk Services Group and
Executive Vice President of Business Development at MedLogix, Gelb’s direct experience in
healthcare, managed care, network development and mergers and acquisitions will greatly benefit our
expanding business model,” states Joshua Carder, Chief Executive Officer at the United Claim
Solutions Family of Companies. “UCS and its family of companies have great histories of innovative
solutions that consistently exceed the expectations of their customers. I am excited and proud to join
this team of professionals and look forward to being a part of our continued success going forward,”
adds Gelb.

https://www.valenzhealth.com/wp-content/uploads/2019/05/News-Image-FPO-1@2x.png 432 600 ryan kesner http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png ryan kesner2019-01-14 12:00:462019-09-20 23:01:26The UCS Family of Companies Welcomes a New Executive Growth Leader

United Claim Solutions Completes Acquisition of Zebu Compliance Solutions

June 20, 2018/in Featured, Press/by ryan kesner

United Claim Solutions (“UCS”), a Great Point Partners-backed company, has acquired Portsmouth, Ohio-based Zebu Compliance Solutions (“Zebu”). Zebu is a software enabled business, providing payment integrity and ongoing credentialing solutions to payors, clearinghouses, and provider organizations across the United States. The acquisition of Zebu brings additional resources and capabilities to UCS, augmenting its suite of payment integrity solutions and expanding its customer base.

“UCS and Zebu have had a strong working relationship over the past seven years. Formalizing our partnership with Zebu enhances our service offering and technology capabilities, enabling us to better serve our clients’ needs,” Josh Carder, CEO of UCS, stated. “Zebu brings us an experienced and talented team, led by industry veteran Francesca Hartop, Zebu’s Founder and CEO. Francesca has deep industry knowledge that has helped establish a comprehensive suite of tools across both payor and provider markets.”

“The Zebu-UCS platform will facilitate high-value integrated and complementary services to better serve our existing customers and further extend our product offerings into new customer segments. Our goal is to create efficiency and integrity across the health care landscape. Zebu’s partnership with UCS creates a comprehensive suite of health care claims management and compliance solutions,” commented Ms. Hartop.

As added by Noah Rhodes, Managing Director of Great Point Partners, “the addition of Zebu provides UCS with added scale and access to over 1,000 new customers. Zebu’s technology, knowledge base and product suite will help UCS continue to improve its payment integrity solutions.”

https://www.valenzhealth.com/wp-content/uploads/2019/09/Office-Technology-Blog-Image.png 432 600 ryan kesner http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png ryan kesner2018-06-20 12:00:142019-09-26 23:31:17United Claim Solutions Completes Acquisition of Zebu Compliance Solutions

Great Point Partners-Backed United Claim Solutions Completes Acquisition of INETICO

August 16, 2017/in Featured, Press/by kamryn cain

Great Point Partners (“GPP”) today announced that United Claim Solutions (“UCS”), a GPP II portfolio company, has acquired Tampa, Florida-based INETICO. INETICO focuses on providing health care cost containment services to self-funded, third party administrator (“TPA”) and stop-loss clients across the United States and Puerto Rico. The addition of INETICO brings additional resources and capabilities to UCS and will augment its suite of payment integrity solutions.

“UCS’ acquisition of INETICO expands our service offering and further deepens our commitment to the highest level of customer service when addressing our clients’ needs,” Josh Carder, CEO of UCS, stated. “The addition of INETICO brings us a great team, led by Founder, CEO, and industry veteran, Joe Hodges. Joe has a record of exceptional service, products and quality in the payment integrity industry.”

“UCS and INETICO joining forces will help drive innovation in the payment integrity market. The addition of INETICO will add care management and new repricing services to UCS, and will help UCS continue to drive down health care costs for our clients,” added Noah Rhodes, Managing Director at Great Point Partners.

“We believe that together, our two companies will create a leader in payment integrity solutions. Our goal is to work with our self-insured, TPA and stop-loss clients to create a one-stop shop for their cost containment needs. UCS’ savings rates and innovative solutions combined with INETICO’s care and negotiation services will be a driving force in the industry,” commented Joe Hodges, Founder of INETICO.

In conjunction with this acquisition announcement, UCS is also unveiling NX Health Network, its high-performance custom network solution for self-insured groups that reduces medical costs and increases patient and provider satisfaction.

https://www.valenzhealth.com/wp-content/uploads/2019/09/Care-Blog-Image.png 432 600 kamryn cain http://www.valenzhealth.com/wp-content/uploads/2021/02/logo-2-21-1.png kamryn cain2017-08-16 19:35:482019-09-20 23:03:05Great Point Partners-Backed United Claim Solutions Completes Acquisition of INETICO
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