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Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Differentiators
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Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:
VALER is a cloud-based **Enterprise Authorization Platform** that streamlines and automates today's manual authorization workflows. VALER provides **ONE place to SUBMIT and VERIFY authorizations across all payors and all services types** (professional, facility, ancillary, medications, etc). VALER is the only solution that manages authorization submissions for both payor **FAX** and **web portal** based workflows. VALER provides enterprise-wide visibility on **real-time authorization status** and documentation to eliminate duplicate work and support the revenue cycle.
About Valer:

Valer provides innovative, cloud-based workflow optimization and automation solutions for administrative healthcare transactions.

Our Valer platform streamlines and automates prior authorizations, eligibility verification, and referrals document management in one, easy-to-use workspace. Valer eliminates paper fax and integrates with payer web portals to automate prior authorizations. Valer improves office staff productivity and reduces the cost of managing prior authorizations. Valer eliminates manual data entry errors with prior authorizations that impact the revenue cycle. Valer delivers the benefit of automated electronic transactions today with zero client installs and zero interoperability requirements.

Product Description:

Health Systems/ACOs/DSRIPs/CINs

• Reducing patient leakage through SmartMatch decision support and real-time analytics

• Standardizing and streamlining the referral management process across the organization

• Driving operational efficiencies and allowing referral teams to scale more efficiently

PCPs/FQHCs/Dental Practices

• Matching patients with most appropriate providers using SmartMatch decision support

• Closing the feedback loop with specialists and reducing phone calls and faxes

• Increasing patients LTV to ensure they are not lost to competitors after referrals are sent

Specialty Care Organizations

• Increasing referral volume and capturing more revenue using CRM and marketing tools

• Improving customer service with referring providers through automated status reports

• Managing referral network and gaining insight into referral patterns using analytics

About ReferralMD:

ReferralMD delivers proven referral management, patient access and e-consult solutions that help hospitals, health systems, networks, and payers streamline the referral process, decrease patient leakage and improve communication between providers and patients. The enterprise platform matches patients with the most appropriate providers and closes the feedback loop between providers and patients. The solution’s powerful workflow and clinical decision support tools help healthcare providers increase revenue, drive operational efficiencies and improve customer service. To learn more about ReferralMD, please visit www.getreferralmd.com.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

VALER can be configured to identify highly targeted information regarding authorization requirements and/or services which are "no auth required." VALER has the ability to work with select payers to provide authorization requirements, "no auth required" alerts, and authorization submissions via real-time APIs (application programming interfaces) where available.

VALER maintains both historical data on actual authorization requirements (clinical data and relevant provider, facility data) and has the ability to implement highly targeted business rules to avoid unecessary errors and denials.

VALER comprehensively automates completion and submission of prior authorizations for 1,000+ unique payer fax forms and 75+ payer web portals.

VALER's form library maintains and updates over 1,000+ payer authorization fax forms across all service lines (diagnostic imaging, surgeries, procedures, chemo/infusion, medications, notice of admissions, DMEs, sleep, Worker's Comp). VALER's proprietary technology can add any new fax form for users typically within 24 hours to support authorizations and referrals.

VALER provides the ability for users to easily attach any relevant clinical documentation to a prior authorization for submissions. VALER supports various file formats needed for submission. VALER also captures documentation from payers regarding approval tracking codes, expiration dates, units of service, CPTs approved, which can be pushed directly back into EHRs/practice management systems to avoid manual data entry. VALER also has Epic's x275 clinical document exchange functionality live in production to directly exchange information from Epic to VALER and back.

VALER comprehensively SUBMITS prior authorizations across both fax and web portal modalities across all-payers and all service types. VALER provides ONE interface, deeply integrated with EHR workflows to automate both today's manual authorization submission and verification workflows.

VALER provides automated authorization status verification across 75+ payer web portals. Authorization information (tracking numbers, units, expiration dates, sites of service, CPT/family of codes approved can be automatically pushed back into EHRs in an automated process further eliminating the need for manual data entry.

Use Cases

Description:

VALER provides health systems, hospitals, and ambulatory clinics with one place to streamline, automate, and manage today's manual prior authorization workflows. VALER saves time, cost, and reduces patient access denials and avoidable write-offs.

Pediatric use cases:

Pediatric health systems and clinics utilize VALER to reduce the time and cost involved with today's manual prior authorization and referral workflows.

Users:

patient access teams, ambulatory clinic authorization teams,  admitting/scheduling teams, revenue cycle teams

Description:
  • Improve patient access through online provider directory and scheduling
  • Improve visibility of provider affiliations across the network and reduce leakage
  • Close the feedback loop, improve loyalty, and increase revenue from referring providers
  • Triage and match patients with the best providers with clinical decision support checklists
  • Communicate with online messages and consults versus fax or phone calls on hold
  • Reduce lost referrals due to improper handling, poor workflow, or antiquated e-fax technology
  • Acquire and retain patients with provider relationship management software (CRM)
  • Reduce no-show rates and improve engagement through automated patient communications
  • Connect different EMRs using ReferralMD as the bridge for interoperability
Pediatric use cases:
  • Pediatric providers can send or receive referrals and communicate with referral partners and patients via the platform.
Users:
  • Care coordinators, referral coordinators, authorization processors, schedulers, marketing representatives, physician liaisons and managers log into ReferralMD. 
  • Clinicians stay within their respective EHR systems since data is exchanged via EHR integrations.

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Community based organizations, ADT, Access +/or revenue cycle, Website / public online sources

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Allscripts, NextGen, athena

Hardware Compatibility:

Desktop

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Pop health platform, Home health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis

Hardware Compatibility:

Desktop, Mobile / Tablet (web optimized)

Client Types

Differentiators

Differentiators vs EHR Functionality:

VALER provides comprehensive coverage of **all payor authorization workflows (fax, phone, web portals) ** and rapidly updates new or changing authorization requirements.

VALER serves as a **single point of integration** and maintains changing requirements for all payor authorization workflows across fax, phone, and web portals.

VALER flexibly integrates with EHRs and practice management systems to reduce manual data entry and scanning of documents

Differentiators vs Competitors:

VALER streamlines and automates today's highly manual **AUTHORIZATION SUBMISSION** and **VERIFICATION** workflows with proven results of 45% reduction in staff time and 11% improvement in staff productivity.

VALER covers **all service types** including professional, facility, technical, medications, and DME authorization workflows
VALER provides **real-time data** on authorization processing times, staff productivity, payor behaviors/turnaround time to optimize prior authorization workflows VALER allows for **coordination and collaboration across the enterprise** to reduce duplicate work and errors between ambulatory clinics, facility admitting/scheduling, and the revenue cycle teams.   

VALER promotes **clean claims** by **standardizing** and **streamlining** authorization submission by injecting **payer rules** in the workflow to reduce costly denials

Differentiators vs EHR Functionality:
  • Online Scheduling – new patients can book appointments from your website without setting up an EHR patient portal account
  • Referral Management – website portal for receiving referrals, customized workflow, automated alerts when referrals need attention
  • Patient Communications – automated text/email messages sent to patients triggered at specific steps in the consult or referral journey
  • Provider Communications – automated consult and referral status updates sent to sending providers to close the loop between PCPs and specialists
  • Fax Management – manage all inbound faxes and push faxed referrals into the referral workflow, ability to split faxes into multiple documents
  • Marketing CRM – physician liaisons can document outreach and compare outreach activity with referral volume from their partners
  • Market Research – over 7 million providers pre-loaded which allows you to identify new potential referral partners in your target markets
  • Referral Analytics – comprehensive suite of analytics to report on all your referral metrics (trends, volume, leakage, service levels, outreach, etc.)

Differentiators vs Competitors:

Differentiator 1: All-In-One Platform

  • Some vendors offer patient access, referral management, e-consults or CRMs. Our cloud-based platform offers them all plus the following features.
  • Real-time analytics across the platform
  • Automated workflow and decision support tools
  • Automated feedback loop with referring providers
  • Automated patient communications via text or email
  • Integrated fax management system (port over existing fax numbers)
  • Integrated Customer/Partner Relationship Management (CRM/PRM)
  • Marketing research tools based on a directory of over 7 million providers

Differentiator 2: Rapid Integration Capabilities

  • Our integration engine allows our Integrations Team to quickly deploy system interfaces using APIs, FHIR, HL7, Direct, etc. which is important when implementing the platform for health systems, ACOs and CINs with many EHRs, data warehouses and other third-party systems across their networks.  
  • In addition, we comply with the third-party system’s specifications rather than asking the vendor to follow our requirements which streamlines the integration process and reduces cost for the client. 

Differentiator 3: All Healthcare Referrals Supported

  • The system is highly configurable and can support all healthcare referral types such as medical, specialty care, therapy, imaging, dental, behavioral health, hospice, home care, etc.  
  • The customization in the system allows clients to define their own workflows, referral forms, patient communication templates, and other settings that can be standardized across the organization.

Keywords

Images

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Videos

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Company Details

Founded in 2010

Founded in 2011

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