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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:

DataMD: Automate & Accelerate Medical Underwriting Processing

Medical underwriting plays a critical role in life and health risk assessment. With AI, underwriting processes can be automated and simplified, empowering underwriters to deliver efficient and smart decisions while adhering to regulatory requirements.

DataMD is an underwriting automation solution that is designed to digitize and analyze complex medical data in diagnostic reports, irrespective of the format or medical nomenclature. Furthermore, the solution helps improve underwriters' efficiency by boosting their productivity and enabling fraud prevention and detection.

Benefits of Using DataMD:

  • Reduced TAT- Cashless claim discharge within 30 mins
  • 80% reduction in financial leakages
  • Up to 50% increase in productivity of underwriting staff
  • More than 95% of data captured accurately via automation
  • Accurate identification of special cases for audit


About i3systems:
i3systems is a healthcare machine learning product company, with a particular focus on the insurance clients. Our system can work on a variety of documents and unstructured data-sets to create an extremely high-quality data essential in predictive modeling, process automation, and decision making. The company has created unique frameworks which blend computational linguistics, machine learning / AI models, image processing, NLP, quality-control rule engines, interactive interfaces; in order to solve a wide variety of problems associated with Underwriting and Claims decision making in health and life insurance companies. Company's products i3claim, DataMD, DigiTariff and TBots perform process-automation, straight-through-processing with zero manual-touch-points, fraud detection, and Multi-dimensional risk stratification in Claims, Underwriting, Tariff digitization processes. We are Leaders in Health Insurance market today because of our innovative platforms and commercial structure. We have proven our capabilities across large enterprise clients in India and Globally helping the likes of AXA Gulf, Bajaj Allianz, ICICI Lombard, Healthcare TPAs, etc. achieve: • Over 50% reduction in operational costs, • Our AI/NLP based models help in achieving more than 90% accuracy, • 70% decrease in processing time, • 300% improvement in skilled FTE productivity, • 90% reduction in leakages due to insufficient data and capture errors, • With 0% compromise on information security.
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

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:

Automate & Accelerate Medical Underwriting Processing


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

None provided

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 2016

Founded in 2010

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