Vālenz® Health Assured Payment

Say goodbye to balance billing for the majority of your claims

Vālenz® Health Assured Payment offers assured payment options for the vast majority of claims for self-insured employers who select an open-access solution or a contracted network. This data-rich solution minimizes the risk of balance billing, member disruption and provider friction for the largest percentage of your claims.

Comprehensive support for maximum cost savings

Through our proprietary V3 Repricing Engine and VMS® analytical algorithm, we blend payment, cost and charge-based data sets together with biometrics and clinical data to produce reimbursement recommendations that are fair, defensible, transparent and consistent for everyone.

From there, we engage early and often with providers in your market to accelerate negotiations and secure up-front discounted agreements. The result: Our Assured Payment program provides fast and seamless reimbursement for the highest percentage of your claim volume.

For the remaining claims, we deploy the full power of our data-driven platform, including expert, line-by-line bill review with fully integrated transparency tools to ensure medical necessity, reasonableness and cost savings. Our detailed analysis creates even more value for payers, providers and patients by pinpointing additional savings opportunities and facilitating strategic decisions to drive long-term savings, expand your provider network and improve your members’ experiences.

Improve cost, quality, member experiences and provider-payer relationships

Valenz Assured Payment delivers many advantages for all stakeholders:

  • Assured payment on the majority of your claims
  • Savings improvement opportunities of 20-40%
  • Accelerated negotiations to secure up-front discounted agreements
  • Expert bill review with provider sign-off for secured savings
  • No member disruption or provider friction for highest percentage of claims
  • 140% Medicare factor
  • Appeal rate <3%
  • Full-service claim management

Added benefits from integrated care navigation

Our contracting experts continuously expand and develop new agreements with providers and facilities behind the scenes, while NaVcare care navigators help ensure your plan members receive the right care in the right place from the right providers.

Valenz Assured Payment with NaVcare:

  • Guides your members to high-quality care
  • Coordinates virtual care where available
  • Assists with appeals if incurred
  • Facilitates appointments, including rides as needed
  • Coordinates cost-effective pharmacy solutions
  • Answers questions about plan benefits and out-of-pocket costs
  • Connects members to helpful health resources

Get Started Today

Where other companies limit services to network design or care management, we go infinitely further: We bring member-centric services and data-driven insights into the patient journey, connecting the dots at every step for lower-cost, higher-quality healthcare.

Contact us today and we will provide a real-life view into the network savings your organization will experience with Valenz Assured Payment. Engaging early and often for smarter, better, faster healthcare – that’s the Valenz promise.

Complete the form below or call us at (800) 834-2312 to get started with Valenz today.

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Valenz Network Design Solutions Suite

Explore the full breadth and depth of customizable, cost-saving options available in our Network Design Solutions Suite:

Contracted Network

Builds a new provider network to improve access, drive a higher standard of care and increase savings.

Contracted Networks are rigorously vetted, quality-first networks of top-performing physicians, hospitals and ancillary providers. We use advanced cost, quality and outcomes analytics to custom build and continuously optimize your high-value, high-performance contracted network.

Open Solution

Maximizes plan dollars with a non-network reimbursement strategy that fosters equitable provider relationships.

Open Solution, an open, non-contracted reimbursement approach with NaVcare, provides an excellent alternative to standard reference-based pricing agreements. Our model provides transparent quality and outcomes data for fair, defensible and consistent reimbursement recommendations.

MEC Solution

Replaces wrap networks with Minimum Essential Coverage for assured payment and minimal risk of balance billing.

MEC Solution is an open-access network solution, complete with assured payment options that minimize member disruption and provider friction for the vast majority of claims. Includes access to high-quality providers and facilities at fair, reasonable costs for substantial savings improvement.

Assured Payment

Eliminates the risk of balance billing, member disruption and provider friction for the majority of your claims.

Assured Payment delivers assured payment options for our Open Solution, Navigated Network or Contracted Network solutions. We blend payment, cost and charge-based data with biometrics and clinical data for fair pricing, integrating comprehensive bill reviews to ensure accuracy.