Unlock Higher Savings with Bill Review
Improve Financial Performance by Uncovering Coding Errors on High-Dollar Claims
Eliminate Errors from Medical Claims and Bills
Your Comprehensive Review for Compliance and Cost Savings
By leveraging advanced AI and experienced clinical and coding teams, Valenz Bill Review verifies medical necessity, provider credentials, and contract alignment on a pre-pay or post-pay basis — ensuring every claim is accurate, compliant, and cost-effective to deliver savings that exceed expectations.
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<1%
rate of reviews overturned by providers
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>10%
savings on second-pass reviews
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70%
average provider signoff rate
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6-day
average turnaround for document procurement
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17%
additional savings above network allowable on claims with identified savings
Review and Verify Charges Before Payment
Reduce Your Spend and Improve Claim Accuracy
More than 80% of complex, high-dollar hospital bills contain errors, costing health plans, TPAs, and clients millions of dollars in avoidable payouts.
Vālenz Health® identifies those errors early on, ensuring appropriate charges are accounted for on every claim.
Itemized review of hospital and provider bills
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Medical necessity review and validation
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Modular design adaptable to your processes and needs
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Available on a pre- or post-pay basis
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Clinical Review
Clinical review of complex, high-dollar, or unusual claims assesses appropriateness of care, determines treatment justification, prevents excessive payments for unnecessary care, and more.
Valenz Health has attained a HITRUST i1 certification for its Claims system.
HITRUST certification validates Valenz is operating leading security practices to protect sensitive information.
Trust in clinical evaluation by a licensed medical professional
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Assess medical necessity and appropriateness of care
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Evaluate compliance with plan provisions for speedy reimbursement
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Reduce risk of overpayment
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Support fair, evidence-based payment
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Diagnostic-Related Groups (DRG) Pricing Validation and Review
Verify that a hospital’s billed diagnostic-related groups (DRG) matches the documented medical care, identify cases where expensive DRG is used incorrectly, and control healthcare spending through expert claim review and validation.
Ensure accurate payment
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Confirm coding compliance
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Detect upcoding or errors
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Support cost containment
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Enhance audit and regulatory compliance
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Pre- or Post-Pay Bill Review
Maximize savings across the entire claims lifecycle by preventing unnecessary payments before they occur or identifying cost-saving opportunities after claims have been processed.
Review high-dollar claims across the entire claims lifecycle
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Identify billing errors before or after payment
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Prevent unnecessary medical spend and missed savings
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Find opportunities to improve future payment accuracy
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Integrate with existing infrastructure and operational requirements
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Post-Payment Recovery
Uncover billing errors, duplicate payments, and incorrect reimbursements in previously paid claims to recover funds and lower your overall healthcare costs.
Identify overpayments after reimbursement
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Recover excess funds
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Support ongoing cost containment
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Enhance data-driven auditing
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Promote accountability and compliance
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All Your Health Insurance Solutions on One Platform
Explore the Vālenz Health® Integrated Platform for Simplified Healthcare
Seamlessly unite member experience, payment integrity, provider quality, and plan performance with our integrated platform. Discover how we optimize the utilization of high-value healthcare across the entire member journey.
Greater Savings, Efficiency, and Experiences
Valenz Bill Review Case Studies
$900K+ Savings and Rapid Care with Early Engagement Strategies
Through pre-negotiation, Valenz collaborated across broker, carrier, employer group, provider, and third-party administrator to achieve significant savings and expeditious care for a member requiring complex surgery.
Uncovering $120M in Errors and Overpayments on High-Cost Claims
A large commercial health insurance carrier retained Valenz to drive additional savings by uncovering errors and overpayments across high-dollar, in-network claims.
In total, Valenz delivered $120 million in savings in addition to network savings — a $40,000 average savings per claim.
Your Frequently Asked Questions, Answered
Bill Review FAQs
Ready to Simplify Self-Insurance?
Your Journey Starts Here
Connect with a Valenz team member to explore the difference our solutions can make for you.
