Ensuring clinically proven, cost-effective care
When medical issues arise, patients need prompt and personalized service – always at the appropriate level of care. Utilization Management from Vālenz Care ensures the right care at the right place and time, paving a more cost-effective path to healthy outcomes.
As soon as we are notified of a new diagnosis or treatment recommendation, our highly trained Utilization Management nurses conduct a clinical review to determine medical necessity and ensure alignment with the most appropriate level of care according to evidence-based guidelines for that diagnosis. To deliver cost savings for the plan and plan members, we combine those guidelines with advanced analytics from our Vālenz ecosystem to facilitate high-quality care while eliminating expenses tied to unnecessary, unproven or excessive treatments.