Lower the cost of air transport
VMS® repricing methodology protects plans, members from surprise out-of-network billing
Today, 71% of air ambulance claims involve out-of-network charges, which lead to egregious costs for health plan members and payers. In fact, the median billed charges for air ambulance services are now $50,000-$75,000 per trip, representing indefensible costs – estimated to be 7 to 10 times what would be considered reasonable.
To protect self-insured health plans from escalating surprise medical bills for emergency air transport, Vālenz® Health deploys a VMS®-validated repricing methodology to control costs and assure full compliance with the air ambulance requirements of the No Surprises Act (NSA). When VMS® combines with our proprietary cost-based methodology, we can create a defensible, market-sensitive qualified payment amount (QPA) for air ambulance services. The result is fair pricing that assures a uniform level of protection for out-of-network air transport.
The Valenz Air Ambulance data-driven solution delivers:
- Cost-based Air Transport Repricing: Defensible repricing based on cost of services
- Expert Clinical Analysis: Experienced RNs conduct clinical reviews and medical expense analyses on every air ambulance claim
- Mitigated Risk of Appeals: Fair, defensible, market-sensitive QPAs reduce or eliminate the need for appeals and independent dispute resolution
- Detailed Supporting Documentation: Receive comprehensive cost analysis reporting with insights into key claim and trip information
Valenz has successfully enabled our innovative repricing methodology to lower costs, enhance care and improve outcomes through quality-first care delivery for more than a decade. Extending this solution to air ambulance claims is part of our longstanding promise to engage early and often for smarter, better, faster healthcare.