Maximize savings and efficiency, improve payment integrity

Payment Integrity

Achieve higher levels of transparency while improving financial performance and assuring the validation, integrity and accuracy of claims.

Provider Network Design

    Market-Sensitive Repricing (VMS®)

    Protect plans and members from surprise out-of-network billing with fair, defensible and market-sensitive QPAs with average 66% of billed charges. Built on a foundation of real-word data from Valenz-contracted provider networks, the VMS® repricing methodology mitigates the risk of appeals and independent dispute resolution.

    NSA Compliance: Qualifying Payment Amounts & Independent Dispute Resolution Simplified

    Proven, data-driven claim management solutions integrate on the Valenz platform to keep you in compliance with the No Surprises Act (NSA). More than a Qualifying Payment Amount (QPA) solution, our end-to-end process embeds everything you need to solve balance billing concerns:

    Leading Expertise

    Consultative specialists lead your QPA application – no need to study NSA.

    Dedicated Support

    Full open provider negotiation, Independent Dispute Resolution (IDR) management and portal support – no portal work for you.

    Data-Driven Approach

    We believe so deeply in our data-driven platform and solutions, if you ever incur an IDR, we pay – no IDR fees for you.

    Reduce Out-of-Network & High-Cost Claims with Specialty Solutions

    ProteKHt Case Studies

    Full claim review case studies illuminate opportunities for significant savings.

    Managing Cost Across the Claim Cost Arc

    Data-driven insights combine with Valenz solutions to allow payers to manage costs across the member journey.

    Capture the Power of the Ecosystem

    Connect with a team member today to learn how the Valenz ecosystem can make a difference for you.