Vālenz Announces Acquisition of Kozani Health

Kozani Health integrates as ValenzProteKHt™ for complete and comprehensive bill review solution

PHOENIX, Ariz. (April 1, 2021) — Vālenz® announced today it has acquired Kozani Health, integrating a new and innovative means for self-funded employers and the self-insured community to control costs across the life of a claim.

Kozani Health, which provides customized solutions to meet the challenges of paying medical claims appropriately, joins the ever-expanding Valenz ecosystem of data and solutions as Valenz ProteKHt™. The new solution offers detailed line-by-line bill reviews performed by nurses, certified coders and practicing specialists to uncover inappropriate billing and care provided.

With success rates averaging 70 percent, Valenz ProteKHt is the industry’s recognized comprehensive and complete bill review solution. Valenz ProteKHt offers clear, defensible, transparent and plan-specific reviews that deliver savings of 10-30 percent above the PPO allowable with a signed contract, agreed upon and authorized by the provider.

“We are excited to welcome Kozani Health as part of our data-driven Valenz ecosystem,” said Rob Gelb, Chief Executive Officer. “By bringing our teams together, we are providing self-funded employers and the self-insured community improved cost savings at each step in the life cycle of a claim, strengthening their ability to realize every opportunity to balance cost, quality and utilization under the Claim Cost ArcSM. Our solutions aside, which clearly align value for all, our cultures and the commitment to customer service and ‘customer love’ will be a continuing defining characteristic of our now, collective success.”

Valenz is focused on changing the trajectory of healthcare expenses, creating new opportunities for self-insured employers to control costs while empowering members to lead strong, vigorous and healthy lives. Valenz delivers a 20-40 percent improvement in savings from traditional health plan approaches by bridging the divide between robust analytics, care management, high-value provider networks, payment integrity and claim management.

“We are energized to begin our company’s next chapter as Valenz ProteKHt,” said Michael Scott, Chief Executive Officer and Co-Founder of Kozani Health. “Integrating our claim management solutions into the Valenz ecosystem will accelerate the growth and evolution of our services and bring value to our customers.”

“With this integration, we assure clients they will experience the same close partnership and personal attention as they have with Kozani Health,” said Heather Wilson, Chief Operating Officer and Co-Founder of Kozani Health. “Now, we can also offer the benefit of being part of the Valenz ecosystem. Together, we are committed to nurturing the same ‘customer love’ that has made Kozani Health a symbol of success in the market.”

 

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 Kozani Health

Kozani Health, headquartered in Mesa, Ariz., provides customized bill review sign-off and bill audit solutions to analyze pricing, coding and care provided to ensure appropriate payment. Since its inception in 2015, Kozani Health has forged long-term customer relationships and continuously improved solutions to solve customer challenges.

About Great Point Partners

Great Point Partners, founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm with approximately $1.3 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, which has $307 million of committed capital. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III) and public equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 200 growing healthcare companies. The private equity funds invest across all sectors of the healthcare industry with a particular emphasis on biopharmaceutical services and supplies, pharmaceutical infrastructure, alternate site care, medical device 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

Vālenz CaptiV: Reduce Risk, Gain More Control of Your Health Plan Spend

As health care costs rise exponentially, self-insured employers are facing greater risks of high-dollar claims. Recognizing the significant risk-reduction advantages and cost-effectiveness of combining employer plans in a medical stop loss (MSL) group captive program, Vālenz® has launched CaptiV to solve the challenges market volatility can pose for small to medium-sized employers.

Valenz CaptiV goes beyond risk sharing to provide a fully integrated, data-driven model for cost and risk reduction. By bringing together employers that are committed to managing their medical costs while improving health outcomes – and equipping them to engage early and often via its end-to-end analytics platform – Valenz CaptiV represents the next generation of MSL group captives.

“We operate at the center of the MSL group captive, actively engaging the group of employers and their employees in our proprietary ecosystem of data and service solutions,” said Rob Gelb, Chief Executive Officer of Valenz. “Our analytic and predictive capabilities uncover new strategies to drive a 20-40 percent improvement in savings by targeting the high-dollar claims that drive the majority of health plan spending. We continually integrate those learnings among Valenz CaptiV members to reduce the potential for catastrophic claims and create value for everyone.”

For self-insured employers with fewer than 1,000 employees, Valenz CaptiV leverages a larger and more diverse population to reduce plan level and catastrophic risk, while delivering exceptional cost-reduction strategies, increased underwriting credibility, and long-term rate stability.

“For captive members, our ecosystem offers unparalleled data-driven collaboration. from pre-claim loss to post-claim resolution,” said Gelb, explaining, “Valenz solutions build on one another, providing actionable information at each step in the life cycle of a claim.”

To accelerate its captive offerings, Valenz partnered with MSL Captive Solutions, the industry’s only platform dedicated to the development and delivery of comprehensive services exclusively for MSL captives. MSL Captive Solutions works with top insurance carriers and claims administrators to deliver market-leading results for Valenz CaptiV members.

“Properly structured group captives have proved to reduce costs and increase plan stability by effectively managing, diversifying and broadly diffusing risk,” said Phil Giles, Managing Director of MSL Captive Solutions. “By taking a discerning approach to membership and enabling more active, data-driven risk management, Valenz CaptiV promises superior performance.”

Together, the firms offer more strategic, proactive risk control and cost-reduction decision-making. And, as costs are contained, Valenz CaptiV members share in the profitability of the program.

For more information on Valenz CaptiV, call (866) 762-4455.

 

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.

 

About MSL Captive Solutions, Inc.

MSL Captive Solutions is the industry’s only platform devoted exclusively to the development of comprehensive (re)insurance solutions for group and single-parent medical stop loss captives.

MSL Captive Solutions provides consultative underwriting support to some of the industry’s leading stop loss carriers and operates independently to work with all qualified brokers, consultants, and captive managers. For more information visit www.mslcaptives.com.

 

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

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.

The Vālenz Payment Solution: Electronic Solutions for Timely and Efficient Claim Payments

PHOENIX, Ariz. (May 12, 2020) – In response to surging demand for electronic claim payments, leaders at Vālenz™ today announced the rollout of the Valenz payment solution. This development further expands the Valenz ecosystem to include fully automated solutions for electronic provider payments.

With the Valenz payment solution, payers and third-party administrators can automate and streamline payment processes for health, dental and workers’ compensation claims – eliminating the delays of manual payment processes and ensuring payments arrive on time. While the need for electronic payment solutions was already on the rise, the widespread shift to working from home has led to rapid acceleration of the Valenz payment solution, now being released ahead of its original late 2020 schedule.

“COVID-19 has presented many unforeseen operational challenges, especially for organizations with manual processes that raise barriers to conducting business as usual right now,” said Jordan Hersh, Vice President, Enterprise Solutions at Valenz, adding that Valenz is dedicated to meeting client needs even as those needs change day by day during the pandemic response. “The current situation called for us to provide electronic payment solutions as soon as possible for our clients, and we were very happy to make that happen.”

The Valenz payment solution enables clients to send provider payments on time and according to their providers’ own preferences, including virtual card payments. Timely, accurate payments are an important part of maintaining healthy relationships with hospitals and providers, and electronic claim payments eliminate manual steps to streamline operations and reduce expenses. With the Valenz payment solution, all payments are processed on a single system of record, regardless of payment type. And, because security is paramount, the platform is HIPAA and NACHA compliant, and it meets all federal and state requirements for electronic payments.

“Simplified payment processes, operational efficiency and clearer communications benefit all health plan partners, especially while working through significant changes in the work environment,” said Rob Gelb, Valenz Chief Executive Offer. “The Valenz payment solution is an important part of our promise to support our clients in achieving smarter, better, faster healthcare.”

Learn more here.

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.

Vālenz Embeds Planwatch into Claim Workflow for Actionable Data

STOW, Ohio (November 1, 2019) – With healthcare spending projected to rise more than 5 percent each year and three-quarters of that spending tied to chronic disease, the need to better manage medical costs has never been greater. To provide self-insured employers, third party administrators, health plans and others with data that drive smarter, more cost-effective decisions, ProServe Health Informatics is pleased to be part of the Vālenz ecosystem.

Through Planwatch, its flagship product, ProServe Health adds deep, integrated financial analytics to fuel Vālenz Claim, a core component of the Valenz ecosystem. By aggregating and mining in-network and out-of-network medical claim data, Planwatch provides intuitive and detailed financial reporting, as well as plan modeling to help direct and systemically lower healthcare spend.

Including Planwatch in the Valenz ecosystem enables more proactive decision-making and a greater opportunity to disrupt the cost curve. “We are leveraging interoperability with partners like ProServe Health to provide actionable business intelligence that helps clients reduce plan costs, not just in the short term but on a more sustained basis,” said Rob Gelb, Chief Revenue Officer at Valenz. “For robust visibility into in-network and out-of-network medical claims savings, Planwatch supports our promise to engage early and often for smarter, better, faster healthcare.”

Georgeann Seuffert, Vice President of Sales at Planwatch, agrees. “We are pleased to take our existing relationship with Valenz to the next level because we share a common goal to provide solutions that substantially influence better health outcomes and reduce total cost of care,” she said. “It is very refreshing to partner with an organization that wants to invest back into their clients. The Valenz commitment to Planwatch as a value-added service speaks volumes about their dedication to healthcare delivery and savings.”

About ProServe Health Informatics

Planwatch is a product of ProServe Health Informatics. It was developed in 2005 by company co-founders who recognized both the need and the solution for an economical, user-friendly, high level data analysis, web-based reporting, benchmarking, disclosure and plan modeling tool for the Payor community. Planwatch examines historical, current, and future health plan dimensions, integrates, combines and compares pharmacy and medical costs, identifies cost drivers and performance metrics, and provides tested solutions to minimize plan expenditures. Query and produce ad-hoc reports by cost, coverage areas, procedure codes, POS, geographical locations, network performance, prescriptions, and over 150 query fields by employer, participant or payor block of business. For more information about Planwatch, visit their website: www.plan-watch.com or contact Georgeann Seuffert, Vice President of Sales at (888) 275-2242 or gseuffert@proservehealth.com.

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. More information is available online at valenzhealth.com. Valenz is backed by Great Point Partners. For more information about Valenz, visit www.valenzhealth.com or call (866) 762-4455.

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.