Vālenz® Health MEC Solution

An open-access, non-contracted network solution complete with assured payment options for minimum essential coverage (MEC) plans

Valenz MEC Solution, the industry-recognized Assured Payment solution, offers employers an open-access, non-contracted network solution, complete with assured payment options for MEC plans. With this innovative approach, you can improve access to quality care, achieve 50-75% cost improvement, and minimize member disruption or provider friction for the vast majority of your claims.

Reduced cost, data-rich solution

The Valenz MEC Solution combines with your health benefits plan to extend favorable reimbursement for MEC plans under the Affordable Care Act (ACA). Unlike traditional MEC network offerings, Valenz MEC Solution enables members to choose high-quality medical providers and facilities to meet their precise health needs, while balancing the financial cost for the member, the plan and the provider. It’s a win-win: Members gain open choice to select higher-quality care for fair and reasonable costs (including lower out-of-pocket expenses), and providers receive reimbursement based on fair, acceptable, market-recognized pricing and geography.

Unlike health plans that offer a specific network (for example, a PPO), Valenz MEC Solution allows members to seek care and treatment for covered services under the plan from any provider. While providers and facilities are not considered “in network,” they are granted favorable rates as a part of their reimbursement agreements.

A whole new level of transparency for lower costs and healthier lives

To deliver fair, defensible, consistent pricing, we use reliable, algorithmic decision-making powered by a proprietary repricing methodology that blends payment costs and market-specific, charge-based data sets. Leveraging the strength of the fully integrated Valenz platform, we drive high-value, non-contracted network solutions, direction of care and high-quality provider utilization. For everything under the Claim Cost ArcSM – from pre-claim decisions to post-claim resolutions – Valenz engages early and often for smarter, better, faster healthcare.

For more insight into the benefits and impact of this solution for members and providers, visit the FAQs below:

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

The Valenz MEC Solution delivers many advantages for all stakeholders:

  • Non-contracted solution to replace wrap networks
  • Access to high-quality medical providers and facilities at fair, reasonable costs
  • Lower member out-of-pocket costs
  • Providers reimbursed based on fair, acceptable, market-recognized pricing and geography
  • Minimizes risk of balance billing
  • Assured payment for majority of claims
  • Savings improvement of 50-75%
  • Full-service claim management

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 the Valenz MEC Solution. 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.

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

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.

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.

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.