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Description
Compatibility Level
Clients
Product Capabilities
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EHR integrations
Client types
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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
InterQual Connect™
InterQual Connect™

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Categories

Solutions

Description

Product Description:
With InterQual Connect™, payers can easily automate all authorization requests, even those requiring medical review, within their existing systems. Providers receive quicker authorization approvals for most requests and payers only need to touch the exceptions that can’t be approved automatically—no more duplicative medical reviews or wasting precious staff time on routine authorizations. - InterQual Medical Review & Authorization: InterQual Connect is a flexible SaaS solution, integrated into payer and provider health information systems. It pairs the leading InterQual® Criteria, now available as a web service, with proven and secure connectivity. - A Unique Solution: The only integrated solution to enable full auto authorization, including medical review. - Uses Existing IT Infrastructure: No new hardware, software or IT staff required. - Easy to Implement: Time to value can be as little as 60 days when using a certified Change Healthcare Alliance Partner. - Provides Fast, Secure Connectivity: Uses the proven authorization gateway. - Keeps Users in Existing Workflows: Providers submit an authorization request, and payers receive the request and medical review from within their current UM/CM workflow. - Delivers Real-time InterQual Access: Just-in-time content from our cloud platform helps ensure you get the latest version, but you can choose when to make the switch. - Aligns with InterQual Hospitals: Payers benefit from the shared clinical language with thousands of InterQual hospitals plus a direct connection to those hospitals already on the InterQual Connect cloud. - Supports Payer/Provider Collaboration: Helps reduce the costs and hassle of prior authorization, while providing full transparency of payer criteria to providers. - Medical Review Service: Optimized for integration, this web service delivers seamless access to the InterQual medical review within your UM/CM system or payer’s provider portal. You get the same leading evidence-based InterQual Criteria combined with our modern, user-friendly interface. The SaaS platform helps you reduce your IT burden, providing realtime access to content. You receive software and content upgrades automatically without waiting for installation and validation, but still maintain control of when to switch to the newer content. You also gain the freedom to make the Medical Review Service available throughout a networked system, such as a multi-hospital and outpatient network or multi-location payer. The Medical Review Service works with any modern browser. - Secure Authorization Connectivity: Our cloud platform and authorization gateway enable the creation of a secure network of connected payers and providers by providing a common language, standard API protocols, access controls and routing rules. Providers transmit an authorization request, complete with an InterQual medical review, through the gateway directly to a payer. The payer system then applies business rules and the InterQual Criteria to this request, and instantly delivers the authorization status back through the gateway to the provider. The gateway has been deployed as part of our cloud solutions, and currently supports thousands of authorization transactions per week between connected payers and providers. It is optimized for our interoperable (XML) medical review format, and can also support the HIPAA X12 278 transaction standards.
About Change Healthcare:
Change Healthcare is inspiring a better healthcare system. We are a leading independent healthcare company that provides data and analytics-driven solutions to improve clinical, financial and patient engagement outcomes in the U.S. healthcare system. Our comprehensive suite of software, analytics, technology-enabled services and network solutions take costs out of the healthcare system by driving improved results in the complex workflows of payers and providers by enhancing clinical decision-making and simplifying billing, collection and payment processes, and enabling a better patient experience. We are creating a stronger and more efficient healthcare system that enables better patient care, choice, and outcomes at scale.
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.

Compatibility level

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Clients

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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:

None provided

Pediatric use cases:

None provided

Users:

None provided

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

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

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

Client Types

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

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

Keywords

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Company Details

Founded in 2007

Founded in 2010

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