Comprehensive support for maximum cost savings
Through our proprietary V3 Repricing Engine and VMSSM 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: Valenz Access Assured Payment 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 Valenz® ecosystem, including expert, line-by-line bill review through Vālenz ProteKHt™, and our fully integrated transparency tools that ensure medical necessity, evaluate reasonableness and drive further 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 Access 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 Access 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