Reduce claim denials, challenges and time-consuming appeals
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments and/or spending time on denial appeals raises costs without improving outcomes. And of course, for the health plan member, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need.
ABN Assistant™ from Vālenz® Health is a provider software solution that delivers prior authorization tools to verify insurance eligibility and validate medical necessity in real time. You can easily print Medicare-compliant Advance Beneficiary Notices of Non-coverage (ABNs) with estimated cost – and you can stop more than 90 percent of medical necessity denials by verifying insurance benefits, eligibility and medical necessity before care is delivered to the patient.
Verification of Benefits & Validation of Medical Necessity – Before Services Are Rendered
ABN Assistant makes it easy to triage and validate medical necessity for Medicare and private payers prior to service delivery. This user-friendly solution is specially designed to verify medical necessity pre-service and generate ABN or private payer notices as needed. Additionally, ABN Assistant includes full reporting, chargemaster, coding and administrative tools – plus unlimited free support from our technical support staff and our team of certified coders.
Best-of-Breed Provider Software & Medical Coding Data
To verify coverage and quickly comply with patient notification requirements, you need accurate, up-to-date data. Paired with DataTank™, the industry’s most reliable curated data libraries, ABN Assistant ensures accuracy for you and eliminates significant time and hassle for your team. Our nationally certified coders and content teams push daily updates, curating and validating thousands of coverage rules changes each week.
ABN Assistant at a Glance
Robust prior authorization tools let you verify insurance and triage medical necessity to reduce challenged denials and the administrative time and effort associated with the appeals process.
Accurately and quickly determines medical necessity and coverage prior to service delivery
Generates patient ABNs/notifications for easy compliance with notice requirements
Includes robust reporting, chargemaster, coding and administrative tools
Customize warnings and coverage instructions
One-click access to original sources and detailed explanations
Expert support from the Valenz team