Vālenz Access Amplified
An open-access, non-contracted network solution complete with assured payment options
Valenz Access Amplified, the industry-recognized out-of-network solution, offers an open-access, non-contracted network solution to replace your wrap network. This solution comes complete with assured payment options, NaVcare care navigation, and expert, line-by-line bill review through Vālenz ProteKHt™. With this innovative solution, self-insured employers and TPAs can improve access to quality care, achieve 50-75% cost improvement, and minimize member disruption or provider friction for the vast majority of health plan claims.
Reduced cost, data-rich solution
Valenz Access Amplified combines with your health benefits plan to extend favorable reimbursement using Market Sensitive Repricing. Unlike traditional wrap network offerings, Valenz Access Amplified 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 offering a specific wrap network that yields low savings, Valenz Access Amplified 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 Valenz ecosystem, 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.
Improve cost, quality, member experiences and provider-payer relationships
Access Amplified 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
- Comprehensive bill review with provider signoff
- Savings improvement of 50-75%
- Full-service claim management
- Integrated care navigation
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.
- 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