Vālenz® Access Assured

An integrated, dynamic approach to Reference Based Pricing, powered by VMSSM

To achieve clarity and balance in the cost-quality equation, Vālenz integrates deep analytical insights with member-centric services, while collaborating with members, providers and payers to ensure transparency. Working within the ecosystem, Valenz Access Assured takes a next-generation approach to Reference Based Pricing models: Through our proprietary VMSSM analytical algorithm, we blend payment, cost and charge data sets to produce reimbursement recommendations that are fair, defensible, transparent and consistent for everyone.

At the outset of care, dedicated concierge professionals assist and steer members toward high-quality care and support their healthcare journey. Should balance billing occur, Valenz provides full member assistance, up to and including legal support.

Valenz Access Assured offers many advantages:

  • Centralized Care Coordination: Dedicated resources serve as the central point of contact for members, providers, and payers channeling members to high quality providers
  • Pre-Service Negotiations: Valenz experts engage immediately to contact providers and negotiate contractual agreements creating transparency of cost and eliminating the risk of balance billing.
  • Balance Billing Support: When contracting isn’t an option and a provider appeals reimbursement levels, we protect the plan and member with comprehensive support for appeals, including negotiations with the provider and legal advocacy.
  • Post-Service Contracting: Valenz contracting experts will support the plan and members through constant expansion and development of new agreements with providers and facilities, driving high-value network development, direction of care and high-quality provider utilization.
  • Seamless Integration: A single-source solution for results integrated with the full Ecosystem.

By engaging early and often, Valenz Access Assured streamlines your path to lower costs and healthier member lives. It’s one of many ways we work closely with data, people, companies and partners to ensure everyone in our ecosystem is strong, vigorous and healthy.