Renal Dialysis Specialty Solution
Reduce your risk for high-cost claims
The skyrocketing expense of dialysis services has made a huge impact on health plans, payers and patients. With charges averaging $6,000 or more for each treatment, self-funded plans need a proactive approach to dialysis claim management so they can limit exposure to catastrophic costs while also protecting the patient.
The Vālenz® Health Renal Dialysis Specialty Solution, as part of our comprehensive Healthcare Ecosystem Optimization Platform, identifies hemodialysis claims and negotiates predictable, lower-cost monthly or annual fixed reimbursement with providers to lower plan costs, eliminate member and provider friction, and positively influence stop loss premiums.
In the absence of a provider agreement, Valenz applies Medicare or our proprietary market-based VMS® repricing to reduce charges and ensure consistency with plan designs. And, as with all our claim services, we manage any resulting appeals. Regardless of the repricing methodology employed, we work with you to ensure pricing is consistent with Medicare Secondary Payer requirements in the event that a member becomes eligible for Medicare coverage.
With 12 years of experience successfully negotiating agreements with the BUCAHs, Valenz engages early in the process to drive lower, predictable costs – typically with a net savings of 70% on billed charges.
The Valenz Renal Dialysis Specialty Solution delivers:
- Negotiated letters of agreements/elimination of balance billing when successful
- Low-cost, flexible fee structures for our services
- Lower, predictable fixed monthly costs for high-utilization/high-cost members
- Alignment between provider and member