PHOENIX, Ariz. (Sept. 9, 2022) —Vālenz® announced today it has acquired Health Cost Control Inc., a national provider of medical cost containment solutions with more than 25 years’ experience. With specialization in claim and cost review services for high-dollar claims, including dialysis, air ambulance and behavioral health billing, Health Cost Control offers custom-designed programs for health plans, third-party administrators, insurance companies and employers.
The fourth company acquired by Valenz since May 2022, Health Cost Control ensures provider adherence to the national guidelines that govern inpatient and outpatient billing, identifying significant savings from inaccurate billing and incomplete documentation. Health Cost Control registered nurses conduct thorough claim reviews for duplication, unbundling, data entry errors and other discrepancies that often go unnoticed and result in higher costs for employer groups. With deep experience covering most clinical settings and understanding related operational costs, Health Cost Control also has expertise in repricing claims to usual, customary and reasonable levels, often garnering 70%+ savings off billed charges.
“We are very excited to welcome Health Cost Control, their clients and their members to the Valenz family,” said Rob Gelb, Chief Executive Officer of Valenz. “In exploring new opportunities to deliver on our core promise to drive smarter, better, faster healthcare, it was clear that the company is an outstanding fit for Valenz. We have partnered with Health Cost Control since 2021 and know we can seamlessly integrate their offerings into our claim management solutions, providing the transparency necessary to lower total health plan spend, improve claim outcomes, and enhance the member experience.”
The Health Cost Control acquisition further fortifies the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that simplifies the complexities of self-insurance. To balance the relationship between healthcare quality, advocacy and cost, Valenz aligns the member, provider, health plan and payer, supported by a steadfast commitment to data transparency and decision enablement. Ultimately, Valenz drives value across clinical and member advocacy, network development, and the validation, integrity and accuracy of claims.
“Our two companies are truly aligned in our cost containment approach and our dedication to innovation, advocacy and quality,” said Carl Papp, CLU, Principal and President of Health Cost Control. “As we continue to serve our clients with customized, flexible programs for reducing healthcare costs, we look forward to becoming an integral part of the Valenz ecosystem.”
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider, health plan and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development, and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
About Health Cost Control
Health Cost Control, based in Texas City, TX, is a leading national provider of cost containment solutions with over 25 years’ experience. The company was founded with the mission that still holds true today: to reduce healthcare costs for clients and ensure that the national billing guidelines that govern inpatient and outpatient billing are adhered to by providers. With specialization in group health claim review, and drawing from a large range of services, Health Cost Control creates a program tailored to fit your needs and deliver optimum results for lower healthcare costs. Learn more at healthcostcontrol.com.
Vālenz® Acquires Fourth Company: Health Cost Control Enhances Medical Cost Savings Solutions for Employers
/in Announcements, Featured, Integrations, Press/by Maris PanjadaPHOENIX, Ariz. (Sept. 9, 2022) —Vālenz® announced today it has acquired Health Cost Control Inc., a national provider of medical cost containment solutions with more than 25 years’ experience. With specialization in claim and cost review services for high-dollar claims, including dialysis, air ambulance and behavioral health billing, Health Cost Control offers custom-designed programs for health plans, third-party administrators, insurance companies and employers.
The fourth company acquired by Valenz since May 2022, Health Cost Control ensures provider adherence to the national guidelines that govern inpatient and outpatient billing, identifying significant savings from inaccurate billing and incomplete documentation. Health Cost Control registered nurses conduct thorough claim reviews for duplication, unbundling, data entry errors and other discrepancies that often go unnoticed and result in higher costs for employer groups. With deep experience covering most clinical settings and understanding related operational costs, Health Cost Control also has expertise in repricing claims to usual, customary and reasonable levels, often garnering 70%+ savings off billed charges.
“We are very excited to welcome Health Cost Control, their clients and their members to the Valenz family,” said Rob Gelb, Chief Executive Officer of Valenz. “In exploring new opportunities to deliver on our core promise to drive smarter, better, faster healthcare, it was clear that the company is an outstanding fit for Valenz. We have partnered with Health Cost Control since 2021 and know we can seamlessly integrate their offerings into our claim management solutions, providing the transparency necessary to lower total health plan spend, improve claim outcomes, and enhance the member experience.”
The Health Cost Control acquisition further fortifies the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that simplifies the complexities of self-insurance. To balance the relationship between healthcare quality, advocacy and cost, Valenz aligns the member, provider, health plan and payer, supported by a steadfast commitment to data transparency and decision enablement. Ultimately, Valenz drives value across clinical and member advocacy, network development, and the validation, integrity and accuracy of claims.
“Our two companies are truly aligned in our cost containment approach and our dedication to innovation, advocacy and quality,” said Carl Papp, CLU, Principal and President of Health Cost Control. “As we continue to serve our clients with customized, flexible programs for reducing healthcare costs, we look forward to becoming an integral part of the Valenz ecosystem.”
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider, health plan and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development, and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
About Health Cost Control
Health Cost Control, based in Texas City, TX, is a leading national provider of cost containment solutions with over 25 years’ experience. The company was founded with the mission that still holds true today: to reduce healthcare costs for clients and ensure that the national billing guidelines that govern inpatient and outpatient billing are adhered to by providers. With specialization in group health claim review, and drawing from a large range of services, Health Cost Control creates a program tailored to fit your needs and deliver optimum results for lower healthcare costs. Learn more at healthcostcontrol.com.
Vālenz® Promotes Kaylee Davis to Client Services Executive
/in Announcements, Featured, Press/by Maris PanjadaVālenz® is pleased to announce Kaylee Davis has been promoted to Client Services Executive. Davis brings expertise with Valenz ProteKHt™ and account management with client-centered service to this new role.
Davis was previously Supervisor of Claim Operations with Valenz ProteKHt. In her new role under the leadership of Brian Campbell, Vice President of Client Services, she will assist clients with new opportunities and solutions from Valenz, ensuring strong, vigorous and healthy client relationships.
“Kaylee showed an aptitude for exceptional client service when she first started with Valenz,” said Campbell. “Her rapport with clients is just one of the many reasons she’s been promoted twice since her relatively recent arrival at Valenz. We’ve consistently witnessed her work ethic and seen her commitment to delivering on the promise of smarter, better, faster healthcare.”
Davis joined Valenz in 2019 with a background in community healthcare. She has a degree from the Brooks College of Health at the University of North Florida in Health Administration. Before Valenz, she worked with healthcare volunteers and engaged the community at a charitable healthcare clinic in Florida.
For more information about Valenz and its leadership and client services teams, visit valenzhealth.com.
Vālenz® Announces Acquisition of Certus Management Group and Launch of Medical Stop Loss Insurance Solution
/in Announcements, Featured, Integrations, Press/by Maris PanjadaPHOENIX, Ariz. (Aug. 12, 2022) — Vālenz® announced today it has acquired Certus Management Group Stop Loss, Inc. (CMG), a managing general underwriter providing certainty of stop loss protection to self-funded employee benefit plans since 1998.
CMG will become a Valenz Affinity Company and part of the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that simplifies the complexities of self-insurance through data transparency and decision enablement throughout the life of a claim. Additionally, the acquisition creates a new private label medical stop loss insurance solution, launching in market as a Valenz V-Rated solution. This solution enables the more efficient delivery of medical underwriting and risk mitigation services tailored to the needs of Valenz clients. All other CMG underwriting services will continue to be offered under the CMG trade name.
The Valenz V-Rated solution is an additive benefit for self-insured employers who engage with Valenz for a full ecosystem solution, including care management, member navigation enhanced with Care Value Optimizer (charity care and centers of excellence bundles), specialty drug solutions, contracted and open access success networks, and high-cost claim cost containment programs. When partnering with Valenz during the presale process, clients realize the full value of the ecosystem which allows them to contain medical costs more aggressively than less innovative offerings, while also potentially resulting in more competitive stop loss costs.
“We’re thrilled to welcome CMG to the Valenz family,” said Rob Gelb, Chief Executive Officer of Valenz. “Our companies are a great match for each other in their commitment to transparency, risk management, and financial protection from high-cost claims and escalating pharmaceutical and treatment costs. As Valenz continues to evolve and expand, we are excited to begin this new collaboration in delivering on our core promise: engaging early and often for smarter, better, faster healthcare.”
CMG will retain its trade name and adopt a new tagline: “A Valenz Affinity Company,” with a slightly updated logo to facilitate a more rapid association with Valenz. The core team of 18 will continue to remotely support CMG-integrated products and services at its current headquarters in Indianapolis.
“CMG and Valenz share a deep commitment to financial assurance for the self-insured industry, while also advocating for plan members and ensuring high-quality, cost-effective care,” said Brad Lewis, President and Chief Executive Officer of CMG. “As we join the Valenz team, we look forward to protecting and serving our clients as an integral part of their innovative, data-driven ecosystem.”
CMG’s line of stop loss products limits liability and eliminates the pitfalls that many employers view as obstacles to self-funding. It offers plan design and risk analysis, stop loss underwriting, firm renewals, and a guaranteed “no laser” contract for groups of all sizes – for plans of 11 participating employees and larger with specific retention levels from $10,000. CMG’s claim procedures also protect self-funded employers from cash flow issues that can result from unpredictable claim activity.
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
About CMG
Certus Management Group has developed a line of stop loss products that limit the liability of a self-funded employer and eliminate the pitfalls that many employers view as obstacles of self-funding. With more than 350 years of combined experience in the stop loss business, the CMG staff is among the most qualified in the industry. This experience enables CMG to provide employers with stop loss solutions that bring certainty to their self-funded plan. CMG maintains a strong relationship with two carrier partners, SiriusPoint America Insurance Company (Rated A- (Excellent) by A.M. Best), and Gerber Life Insurance Company (Rated A (Excellent) by A. M. Best). Each carrier shares CMG’s vision of the stop loss marketplace and offers the stability of a well-established insurance company.
Learn more at certusmg.com.
Vālenz® Promotes Maurice Steenland as Chief Product Officer
/in Announcements, Featured, Press/by Maris PanjadaPHOENIX, Ariz. (Aug. 5, 2022) — Vālenz® is pleased to announce Maurice Steenland has been promoted to Chief Product Officer.
Leading innovation and investment strategy for the Vālenz® Healthcare Ecosystem Optimization Platform, Steenland is highly engaged in synchronizing departments to accelerate strategic initiatives that bring greater value to clients. Steenland also offers deep expertise in uncovering operational efficiencies and engaging data and analytics to enable better decisions.
“With 20+ years of senior leadership experience at leading healthcare organizations, Maurice is our catalyst for ecosystem innovation and scale,” said Rob Gelb, Chief Executive Officer of Valenz. “Through a highly strategic and data-driven approach, he leads our investment strategy, uncovering new solutions to deliver a powerful data platform that enables more proactive decision-making and identifies opportunities to boost plan performance for our customers.”
“A firm believer in the company culture of one, Maurice inspires us every day to engage early and often to deliver smarter, better, faster healthcare,” Gelb added.
Steenland also has held leadership positions at CIGNA Healthcare, Coventry Health Care and Intracorp, with specialization in operations, utilization management, strategy, and business development. He earned his master’s in business administration from the prestigious Wharton School of the University of Pennsylvania.
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
Vālenz® Announces the Acquisition of MCM, Expands Care Management and Population Health Solutions
/in Announcements, Featured, Integrations, Press, Valenz Care/by kamryn cainPHOENIX, Ariz. (July 27, 2022) — Vālenz® announced today it has acquired Medical Cost Management Corporation, d.b.a. MCM Solutions for Better Health and its subsidiary, Med-Care Management, Inc, (MCM), a leading provider of managed care and population health management programs spanning the entire continuum of care for self-funded plans. In May, Valenz announced the acquisition of VerifPoint, a credential verification organization today recognized as VPoint™.
As a Valenz company, the combined MCM and Med-Care subsidiary which have served the multi-employer labor space for more than 35 years, will adopt the trade name Valenz Care. Valenz Care offers member and clinical advocacy through concierge navigation and triple URAC-accredited services for care management, disease management and utilization review. The acquisition accelerates the collective ability to deliver data-driven medical cost management and population health management to labor and public entities, as well as commercial customers.
“Valenz continually explores new ways to deliver on our core promise to engage early and often for smarter, better, faster healthcare, and we are thrilled to now deliver that promise to MCM customers and their members,” said Rob Gelb, Chief Executive Officer of Valenz. “The addition of MCM solutions clearly aligns with the Valenz commitment to deliver care optimized solutions that influence member choices prior to costly healthcare decisions being made. Together, we will prospectively – and continually – address member care needs for improved outcomes and cost containment throughout the member’s healthcare journey.”
The partnership with MCM further fortifies the Valenz Healthcare Ecosystem Optimization Platform, an end-to-end, fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider to enable better decision-making, starting long before care is provided and continuing long after a claim is paid.
“We look forward to introducing our customers to the highly innovative Valenz ecosystem and expanding opportunities to provide cost-efficient and comprehensive care management across the health continuum,” said Thomas J. O’Connor, President of MCM. “Our companies share a dedication to serving the self-insured industry, advocating for plan members, and ensuring high quality, cost-effective care, making our partnership a natural fit.”
MCM, a physician-directed company, is URAC accredited in health utilization management and is licensed in all states with requirements. Its solution portfolio also includes chronic disease management, catastrophic care management, a comprehensive health and wellness program, health risk assessments, predictive modeling, and data reporting.
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
About MCM
A pioneer in medical management, Medical Cost Management Corporation, dba MCM Solutions for Better Health, was founded by Michael O’Connor in 1986 to meet the population health management needs of self-funded plans, Taft-Hartley Trusts, associations and claim payers. MCM and its subsidiary Med-Care Management, Inc., provide services to more than 550 plans representing over 600,000 members nationwide. More information is available at medicalcost.com.
Vālenz® Announces Corporate Sponsorship for HCAA TPA Summit in July
/in Announcements, Events, Featured, Press/by kamryn cainPHOENIX, Ariz. (July 1, 2022) — As Corporate Sponsors of the HCAA TPA Summit, Vālenz® leaders have announced they will join this year’s key networking event in St. Louis for third-party administrators and the self-funded industry.
The HCAA TPA Summit addresses relevant topics and issues for the self-funded marketplace while providing opportunities to connect with colleagues. The annual conference aims to inform and inspire participants as they break through barriers, differentiate themselves in the market, and transform their thinking while self-funding continues to evolve.
This year’s event, with a forward-facing theme of “Gateway to the Future,” will feature discussion topics including value-based care, mission vs. margin, technology as a key step toward advocacy, improving client service while navigating the legal landscape, and much more.
“As always, we’re looking forward to engaging with new and old friends at the HCAA TPA Summit while sharing the benefits of our comprehensive, data-driven solutions,” said Rob Gelb, Chief Executive Officer of Valenz. “We know Third Party Administrators need a platform that delivers data engagement, decision enablement and true transparency to optimize self-funded plans. That’s where the Valenz Healthcare Ecosystem Optimization Platform supports strong, vigorous and healthy lives – and companies — through its fully integrated solution that improves care quality and health outcomes while minimizing costs. We’re excited about sharing more in St. Louis.”
The HCAA TPA Summit will be held July 18-20 at the Hyatt Regency St. Louis at the Arch downtown. Attendees are encouraged to connect with Valenz to explore the benefits to their business and plan members provided by full data transparency, robust analytics, and a unique integration of services across the care and claim continuum that drives smarter, better, faster healthcare.
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
Vālenz® Partners with GenRocket to Produce Test Data Fifty Times Faster
/in Announcements, Featured, Press/by Maris PanjadaPHOENIX, Ariz. (June 30, 2022) — Vālenz®, a tech-enabled healthcare ecosystem optimization platform for the self-insured industry, recently partnered with GenRocket, a synthetic test data automation company, to leverage synthetic test data in its quality assurance process for the company’s next-generation claims processing platform.
According to Garth Rose, CEO and Co-founder of GenRocket, software testing requirements for healthcare industry applications are particularly complex, with strict data privacy regulations along with complex data sets to manage. “Valenz, like most companies, realized using real data posed unacceptable privacy and security risks, and the option to manually create the necessary test data posed undesirable time constraints,” explained Rose.
GenRocket’s synthetic test data automation platform replicated the data model from the Valenz claims application to generate realistic and accurate synthetic data without the use of any PHI during testing and development. “Using GenRocket’s synthetic test data automation platform, we were able to produce 300,000 claim records approximately 50 times faster than a manual method of scrubbing data to produce the required test data for building and testing the next generation of our platform,” said Edward Zwicker, Chief Information Officer for Valenz.
“With GenRocket, we accelerated our time to market significantly, allowing Valenz to re-direct staff to other time-sensitive tasks required for us to deliver a more automated and scalable claims processing platform to better support our customer needs,” added Zwicker.
For more details, read the case study: https://www.genrocket.com/newsletter/private-secure-healthcare-test-data-produced-50x-faster-with-genrocket/
About Valenz
Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.
About GenRocket
GenRocket is the leader in real-time synthetic Test Data Automation (TDA), high-performance technology for provisioning test data for Agile and DevOps environments. GenRocket’s patented, groundbreaking platform accelerates test data provisioning by more than 1,000% as it improves data quality and test coverage while reducing cost and ensuring data privacy. Headquartered in Ojai, California, GenRocket operates in global markets through a network of systems integration partners and has customers in more than 14 vertical markets including financial services, insurance, and healthcare. For more information, visit www.genrocket.com.
Vālenz® is Proud Title Sponsor of SIIA 2022 National Conference in Phoenix
/in Announcements, Featured, Misc., Press/by kamryn cainScheduled for Oct. 9-11 at the JW Marriott Phoenix Desert Ridge Resort & Spa, the SIIA National Conference & Expo is the world’s largest self-insurance event, offering educational programs, meaningful insights and game-changing solutions on the latest industry topics.
“Our sponsorship of the SIIA National Conference this year will bring Valenz full circle,” said Rob Gelb, Chief Executive Officer of Valenz. “We launched the Valenz ecosystem at the national conference in October 2019, which was the last time it was held in person before the pandemic. Three years later, we are celebrating being together again and unveiling the fully integrated Healthcare Ecosystem Optimization Platform. It is a tremendous honor to now say thank you to the SIIA community through the Title Sponsorship in our hometown. We can’t wait for October.”
Valenz has been a Diamond Member of SIIA since 2020, which signifies the highest level of support for SIIA’s mission and demonstrates a leadership position in serving the needs of the self-insurance community.
“We were very excited to announce Valenz as the Title Sponsor for this year’s conference,” said SIIA President & CEO Mike Ferguson. “Not only have they been a great supporter of the organization, but they also are an industry innovator in healthcare cost containment solutions for so many of our members involved with self-insured health plans and captives. With Valenz’s support, we expect Phoenix to be a wonderful host city for our biggest event of the year.”
Gelb will facilitate an “Engagement Accelerator” session at the conference called “Selling in the Self-Insurance Market,” which will address the acceleration of change, the challenges of staffing and other industry developments that may shift the mind of the buyer in the self-insurance value chain. Participants will share their experiences and strategies on how to work most effectively to support the self-insurance industry buyers while achieving corporate growth objectives.
Registration for the conference – along with links to the daily schedule, session topics, speakers, FAQs and more – is available at https://www.siiaconferences.org/2022/register_now.cfm.
About Valenz
Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners. More information is available at valenzhealth.com.
Vālenz®, VerifPoint Announce Integration and Launch of Comprehensive Provider Credentialing Solution
/in Announcements, Featured, Integrations, Press, Valenz Assurance/by Maris PanjadaPHOENIX, Ariz. (May 24, 2022) — Vālenz® announced today it has integrated with VerifPoint, an industry-leading Credentialing Verification Organization for health systems, hospitals, providers and health plans.
The integration of the two companies creates a new solution called Valenz VPoint™, a provider credentialing and continuous monitoring solution that offers effective, diligent credential verification to ensure quality of care for patients and members. As a critical component of the Valenz strategy to assure Validation, Integrity and Accuracy (VIA) for providers, VPoint offers NCQA-certified and URAC-compliant credentialing and re-credentialing solutions.
In addition, VPoint and Valenz Assurance will combine to enhance VIA Provider Solutions, a comprehensive compliance management solution to improve medical coding efficiency, reimbursement assurance, auditing toolsets, claims accuracy, credentialing, medical staff licensing and exclusion monitoring.
“We are thrilled to partner with VerifPoint in accelerating our collective ability to deliver data-driven, analytical solutions for credentialing and continuous monitoring,” said Rob Gelb, Chief Executive Officer of Valenz. “With the launch of VPoint, we are poised to support our clients with reduced exposure and facilitate higher-quality care. This is a clear example of how Valenz continually delivers on our promise to engage early and often for smarter, better, faster healthcare.”
The integration of VerifPoint further fortifies the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider across all phases of the claim life continuum. While minimizing the opportunity for fraud, waste and abuse, VPoint’s credentialing and monitoring services protect clients from denials, appeals, unpaid claims and penalties associated with employing or paying providers with improper licenses or disciplinary issues.
“As we join the highly innovative Valenz ecosystem, we are well positioned to accelerate growth and value for clients together,” said Asim Ashary, CEO and President of VerifPoint. “The two companies share a deep commitment to meeting client-specific needs while proactively anticipating the constant changes in technology and the healthcare industry. We look forward to the next steps toward an exciting future as one united company.”
About Valenz
Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz, ranked two years in a row on Inc. 5000, is backed by Great Point Partners.
About VerifPoint
A Credentials Verification Organization based in Lake Forest, Calif., VerifPoint offers easy and customizable medical credentialing solutions and provides highly affordable, timely and accurate healthcare practitioner information. Our vision is to be the leading service provider for medical credentialing by providing optimum and best system solutions that are fully adaptable to meet the special needs of clients while keeping pace with the ever-changing needs of technology and the healthcare industry. Fully certified by NCQA, VerifPoint provides primary source verification that meets industry and regulatory standards such as NCQA, TJC, URAC, CMS and AAAHC.
Vālenz® Hires John Paolacci as Chief Claims Officer
/in Announcements, Featured, Press/by Maris PanjadaPHOENIX, Ariz. (May 13, 2022) — Vālenz® is pleased to announce John Paolacci, MBA, has joined the company as Chief Claims Officer. With more than 20 years’ experience in managed care and claims, Paolacci has served in leadership roles in client services, operations, strategic planning, managed care product design, pricing, strategic partner contracting, business development strategy and M&A integrations. At Valenz, he will lead the Validation, Integrity and Accuracy (VIA) of claims and payments, implementing tech-enabled solutions that support a robust claim infrastructure for accelerated and streamlined claim operations.
As Chief Claims Officer, Paolacci will partner with Amy Gasbarro, Chief Operations Officer, who ensures early engagement and continuous clinical, member and provider advocacy across the entire healthcare ecosystem. Together, Gasbarro and Paolacci will facilitate a seamless entry for self-insured employers and members into the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider across the Claim Cost ArcSM.
“John is widely recognized as a results-driven, solutions-oriented leader with deep expertise in claim management and cost containment,” said Rob Gelb, Chief Executive Officer of Valenz. “His superior capabilities position us well to continue building a strong foundation in claim operations as our member base grows, and his philosophy of servant leadership aligns perfectly with the collaborative Valenz culture. We are thrilled he is joining the team.”
Most recently, Paolacci was Senior Vice President, Managed Care for Sedgwick, with responsibility for standalone managed care cost containment divisions including medical bill review, provider networks and client services. He also has held senior leadership positions with York Risk, Avizent Risk, and the Frank Gates Service Company.
Paolacci earned his master’s degree in Business Administration at Franklin University in Columbus, Ohio, He lives in Granville, Ohio.
“I’m honored to have the opportunity to be part of such an energetic, collaborative company that is driving true innovation in the market,” Paolacci said. “As we anticipate the needs of our self-funded customers and continue building the next generation claim organization to serve an ever-evolving healthcare industry, I look forward to advancing the business operations and Valenz vision for smarter, better, faster healthcare.”
About Valenz
Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.