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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:
Obtaining pre-authorizations without delay is essential to both preventing unnecessary delays in care and ensuring accurate reimbursement for services provided. But there are multiple challenges to administering an efficient, effective pre-authorization program, including: • Recruiting and retaining staff who have both clinical and revenue cycle expertise • Dedicating resources to stay up to date on complex, evolving guidelines and payer-specific requirements, and to manage payer responses • Lack of a consistent, technology-enabled workflow An Efficient Solution: Our Authorization Management Services staff manages pre-certification and authorization needs for inpatient and outpatient diagnostic and therapeutic services. We also provide comprehensive concurrent or retrospective inpatient authorizations after admission. Our solution includes: • Authorization Experience and Expertise – Our services are provided by clinicians (nurses or allied health depending on client need) who have specialized education in authorization requirements and commercial screening tools. Our team members average more than five years of clinical and authorization experience, stay up to date with training and compliance, and are dedicated to helping ensure that no part of your authorization request slips through the cracks. • A Centralized and Streamlined Technology Process – Our team leverages a centralized system to accelerate payer response, with processes that are efficient and repeatable. We incorporate robotic-process automation to assist with account statuses and system updates. • Thorough Authorization Clinical Review – Our team reviews each medical record, focusing on payer-specific requirements and obtaining authorization for services scheduled or rendered. We stay abreast of changes to Medicare, Medicaid, and commercial payer guidelines. • A Focus on Reducing Authorization-Related Denials – We take a holistic approach to authorization, which includes working auth-related denials. We review denied admissions, days, and services, and complete all necessary steps for reconsideration and appeal requests. Our denial workflow is customized so that we can pair expertise to the type of denial; for example, leveraging technical versus clinical staff depending on the reason for denial. • Detailed Performance Reporting – We provide detailed performance reporting that includes a month-over-month view of account activity including: √ current status √ completion percentages √ approval percentages
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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