Uncover Hidden Savings in Every Claim with Payment Integrity Solutions
Contain Health Plan Costs and Improve Financial Performance
Ensuring Stronger Health Plan Performance
Drive Down High-Dollar Claim Costs and Billed Charges
Keeping your health plan’s financial performance healthy and strong is enough of a challenge. Unfortunately, billing errors, surprise charges, siloed data, and broken claims processes only complicate things further.
Vālenz Health® makes those problems a thing of the past.
Reduce your health plan costs and eliminate balance billing for members with appropriate, defensible payments powered by our suite of Payment Integrity solutions. Improve financial performance and drive better value for clients with our proactive strategy today.
Providing Support for:
Third-Party Administrators (TPAs)
Self-Insured Employers
Brokers and Consultants
Health Plans
Your Unique, Proactive Payment Integrity System
Discover Solutions to Enhance Payment Integrity
Deliver smarter cost containment, reduce operational inefficiencies, and improve transparency for employers and members alike through integration of accurate bill review, market-sensitive pricing, curated data sources, and more.
Clinical Bill Review
Ensure every claim is accurate, compliant, and cost-effective—all before payment is made. By leveraging advanced AI and the expertise of our clinical and coding teams, we verify medical necessity, provider credentials, and contract alignment upfront. Our proprietary methodologies seamlessly enhance your payment integrity strategy, consistently delivering savings that exceed expectations.
In-Network Repricing
Make quality a given by creating a custom network of rigorously vetted, top-performing healthcare facilities and providers in your region with our In-Network (INN) Repricing solution. By using advanced analytics to custom-build high-performing networks and ancillary preferred provider organization (PPO) networks, we ensure you have the right provider network for your members’ needs.
Out-of-Network Repricing
Unlock significant savings for high-cost, low-utilization claims with our comprehensive solution. By focusing on maximizing value and efficiency, we ensure health plans can manage costs effectively while maintaining seamless operations—minimizing out-of-network (OON) spend and supporting a cost-effective plan with OON Repricing.
Clean Claim Verification
Whether you’re a healthcare organization that needs to protect reimbursement revenue or a payer looking to avoid overpayments, Clean Claim Verification enables verification of medical billing codes and coverage with precision. Save your staff time, reduce exposure, and protect your bottom line with our accurate, efficient SaaS solution.
Curated Data Sources
We provide data that is readily available, up to date, and accurate to help you make the best decisions, take the optimal direction, and perform at the highest capacity. Meet the challenges of changing rules, regulations, requirements, standard formats, and more with our efficient SaaS solution, Curated Data Sources.
ABN Medical Necessity Validation
Our provider software solution, ABN Medical Necessity Validation, delivers prior authorization tools to verify insurance eligibility and validate medical necessity in real time, ensuring claim accuracy and eliminating wasted time and effort for your team.
All Your Health Insurance Solutions on One Platform
Explore the Vālenz Health® Integrated Platform for Simplified Healthcare
Seamlessly unite member experience, payment integrity, provider quality, and plan performance with our integrated platform. Discover how we optimize the utilization of high-value healthcare across the entire member journey.
Proven Performance, Powerful Stories
Jeff White
Health Plan Management Group
"Thanks to the robust front-end care navigation solution, Valenz unlocked the true value of [our client's] new plan—members are now guided to high-quality, in-network providers."
Sharon
Health Plan Member
“Love it! With our new plan, not only are my out-of-pocket costs lower, but filling my specialty drug prescriptions is so much easier."
RN
Valenz Maternity Case Manager
“The new mom appreciated the support and was grateful to have prevented unnecessary out-of-pocket costs for the NICU. Her employer was grateful for the cost-savings, too—and for our help in making it possible for their employee and her baby to live strong, vigorous, and healthy lives.”
Ready to Simplify Self-Insurance?
Your Journey Starts Here
Connect with a Valenz team member to explore the difference our solutions can make for you.