Delivering total insight to ensure appropriate payment

With the continued challenges of medical billing accuracy and transparency, self-funded employers and the self-insured community need confidence they are paying medical claims appropriately. Vālenz ProteKHt ensures appropriate and accurate charges are accounted for on every line of every claim, correcting unnecessary, unrelated, irregular or inappropriate medical billing while enhancing the claim management process. Valenz ProteKHt also offers a complimentary prescreen report within 24 hours of receiving the itemized bill.

Industry-Recognized Solution for Secured Savings

Valenz ProteKHt delivers savings 10-30% greater than contracted network discounts complete with a signed contract, agreed upon and authorized by the provider.

With provider signoff success rates averaging 70%, Valenz ProteKHt is the industry’s recognized comprehensive and complete bill review solution. We ensure appropriate, defensible and transparent payments that are secured by signed provider agreements.

Eliminating erroneous, fraudulent and medically unnecessary charges allows the health plan to remain focused on improving outcomes and helping members lead strong, vigorous and healthy lives.

Bill Review Signoff

Secured agreements, high capture rates and deep savings

Detailed line-by-line bill reviews with provider signoff ensures that incorrectly billed charges and clinically inappropriate services are not reimbursed. By consistently securing provider signoff, Valenz ProteKHt eliminates provider appeals and balance billing while delivering significant savings for Valenz customers.

Bill Review

Clear, defensible, transparent and plan-specific reviews

Should providers be unwilling to agree to write off discrepancies that don’t meet industry-standard coding and care guidelines, Valenz ProteKHt offers payers full appeal support for bill reviews. We manage appeal processes with providers directly, and reduce friction by ensuring accuracy, consistency and transparency.

Customer Resources

Expert Peer Review

Our credentialed reviewers offer unparalleled expertise in handling claims and investigating charges. Through a professional team of certified coders, registered nurses, board-certified physicians, licensed pharmacists and licensed social workers, we consistently deliver defensible peer assessments for any type of claim or charge.

Data-Driven Ecosystem

As part of the Valenz ecosystem, data is the fuel behind our engine and allows us to bring exceptional analytical efficiency when examining prices, coding and care to ensure appropriate payment. Through a fact-based, data-driven model and approach, we engage early and often to deliver optimal investigation results and fast turnarounds – within 24 hours of receiving the itemized bill.

Personalized Solutions

We develop personalized solutions that meet the unique needs of our customers, allowing them to remain agile as they navigate a continually evolving environment in claims. Our active partnerships are built on personal attention and the commitment to “Customer Love” – connecting the dots to draw and manage the big picture for superior service.

Savings Revealed

Medical Necessity

Unbundling

Duplicate Charges

Pricing Inconsistencies

Medically Unlikely/Impossible

Line Charge Verification

Code Edits

Experimental and Investigational

FDA Approved

Level of Care

Valenz ProteKHt Case Studies

Children’s Hospital with BUCAH

See how we found opportunities for 13.86% in additional savings above BUCAH PPO discounts, and secured provider signoff to deliver our client $129,648 in net savings.

High-Dollar Claims

Learn how our detailed line-by-line bill review delivered $93,798 in net savings, secured provider signoff and ensured no balance billing to the patient.

Medical Records Review 

See how our credentialed reviewers utilized our fact-based model and strong working relationship with providers to secure signoff on savings 23.8% above the PPO discount in less than two hours.

Reduce Costs and Secure Long-Term Savings with Valenz ProteKHt

We consistently uncover additional areas of savings by delivering transparency through collaboration.

To get started on the path to smarter, better, faster healthcare, call us at (904) 414-3213 or complete the form below.

  • This field is for validation purposes and should be left unchanged.

Valenz News

Vālenz® to Attend SIIA’s 2021 National Educational Conference & Expo

Event to be held October 3-5 in Austin, Texas PHOENIX, Ariz.…

Vālenz® Hires Chris Shoffner as Vice President, Business Development

Shoffner brings expertise and passion for improving health plan…

Integrated Payor Solutions Seals Partnership with Vālenz®

(September 30, 2021) – Integrated Payor Solutions, a full-stack…