Vālenz^® Health Access Assured Payment

Say goodbye to balance billing for the majority of your claims

Vālenz^® Health Access 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 Access 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 Healthcare Ecosystem Optimization 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 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

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 Access 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 Access Solutions Suite

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

Access Contracted Network

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

Access 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.

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Access Navigated Network

Navigates care to in-network providers for lower costs with better outcomes and enhanced member experiences.

Access Navigated Networks add NaVcare care navigation for improved in-network utilization to enhance savings and performance. NaVcare provides a single point of entry with high-touch member onboarding and guidance to immediately drive engagement and elevate the member experience.

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Access Open
Solution

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

Access 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.

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Access Assured
Payment

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

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

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Access Amplified

Provides an out-of-network solution with care navigation and assured payment for secured savings.

Access Amplified is an out-of-network solution with NaVcare and comprehensive bill review with provider signoff. We steer members to high-quality care at fair, reasonable costs and secure appropriate, accurate charges for every out-of-network claim, resulting in significant savings improvement.

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Access MEC Solution

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

Access 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.

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Access Eco Complete

Replaces high-cost contracted network plans for long-term savings and enhanced member engagement.

Access Eco Complete is a fully integrated ecosystem to optimize the value of your Access choice and achieve total savings improvement of 20-40%. Includes supporting solutions for navigation and care management, claim management, high-dollar claim protection, pharmacy solutions and more.

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Experience the Synergy

When we say the Valenz ecosystem is comprehensive, we mean it. With a complete selection of fully integrated wraparound solutions to complement the core solutions featured below, we deliver benefits far greater than the sum of all these parts individually.