V3 Repricing Engine

Ensure fair, defensible market-supported reimbursements

Fueled by the volume, variety and velocity of data within the Vālenz™ ecosystem, our V3 Repricing Engine accelerates fair and accurate claim repricing. Powered by V3, the Valenz ecosystem brings you another solution to impact your program results through smart, strategic decision-making.

How It Works

Aggregating years of robust claims data with industry-leading sources, the V3 Repricing Engine uses the data-rich VMSSM Repricing Methodology to determine fair and market recognized, acceptable reimbursements. Through an algorithm which analyzes payment, cost and charge based data sets, we develop defensible and supported payment recommendations. Our detailed analysis goes further by identifying potential program pain points and opportunities for additional savings, enabling you to provide more actionable insight. For data integrity and timeliness, we continuously scrub and adjust the data as needed to ensure a fair market price for all services rendered.

Benefits of the V3 Repricing Engine:

  • Maximized discounts on low-dollar claims for optimal savings
  • More consistent, substantiated and defensible claims pricing
  • Faster turnaround from a rules-based engine that quickly defines claim pricing
  • Actionable insights to guide decisions, including data-mining capabilities that can reduce the cost of healthcare by identifying patterns and pinpointing high-performing providers with optimal cost structure

The V3 Repricing Engine is fueled by the three Vs of big data:

Volume

Years of historical paid claims data

Variety

Numerous geographical, medical and claim cost data elements

Velocity

Up-to-date charge information using real-time insight