ABN Assistant™

Reduce claim denials, challenges and time-consuming appeals

For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need.

ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.

Validating medical necessity for prior to service delivery

ABN Assistant makes it easy to triage and validate medical necessity for Medicare and private payers prior to service delivery. This user-friendly solution is specially designed to verify medical necessity pre-service and generate ABN or private payer notices as needed. Additionally, ABN Assistant includes full reporting, chargemaster, coding and administrative tools – plus unlimited free support from both our technical support staff and our team of certified coders.

Best-of-Breed Data

To verify coverage and quickly comply with patient notification requirements, you need reliable, up-to-date data. Paired with DataTank™, the industry’s most reliable curated data libraries, ABN Assistant ensures accuracy for you and eliminates significant time and hassle for your team. Our nationally certified coders and content teams push daily updates, curating and validating thousands of coverage rules changes each week.

ABN Assistant at a Glance

Robust prior authorization tools let you triage medical necessity to reduce challenged denials and the administrative time and effort associated with the appeals process.

  • Accurately and quickly determines medical necessity and coverage prior to service delivery

  • Generates patient ABNs/notifications for easy compliance with notice requirements

  • Includes robust reporting, chargemaster, coding and administrative tools

  • Customize warnings and coverage instructions

  • One-click access to original sources and detailed explanations

  • Expert support from the Valenz Assurance team

Claims done right the first time.

When claims are done right the first time, your organization saves time, money, and resources that can be better allocated toward supporting members and caring for patients.

To get started, call us at (888) 395-9029 or complete the form below for us to get in touch with you.

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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.

Vālenz Access

Combine a quality-first provider network or open solution with a range of customized, data-driven services from the Access Solutions Suite.

Vālenz Care

Guide members to better care and outcomes at lower costs, for you and for them, with RN-led, triple URAC-accredited care management.

Vālenz Claim

Reduce costs and ensure accurate payments with comprehensive bill reviews and repricing methodologies, integrated analytics, and more.

Vālenz Assurance

Improve coding, reimbursement assurance, auditing, claim accuracy and compliance monitoring, all while saving time and costs.

v-Lens

Use advanced, drill-down analytics and predictive modeling to continuously disrupt the cost curve without compromising quality.

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