Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
Medical necessity denials represent a significant financial burden for healthcare providers, incurring costs that can reach into the millions annually due to write-offs, along with the expensive labor involved in investigating and contesting these denials while addressing patient inquiries. Conversely, payers also face similar challenges in the claims management process, as they incur expenses from covering unnecessary medical procedures and treatments, as well as the resources dedicated to handling denial appeals, all of which do not contribute to better patient outcomes. Additionally, patients may suffer from excessive copays and other out-of-pocket expenses, coupled with a frustrating healthcare experience due to charges and services that are not warranted. To combat these issues, the ABN Assistant™ from Vālenz® Assurance equips providers with essential prior authorization tools to confirm medical necessity, generate Medicare-compliant Advanced Beneficiary Notices (ABNs) that include estimated costs, and effectively prevent over 90 percent of medical necessity denials by ensuring that the necessity is validated before any care is administered to the patient. By utilizing this system, providers can enhance their financial stability while improving patient satisfaction and care efficiency.
Description
AppealsPlus™ is an innovative cloud solution designed to automatically assess ERAs, apply specific rules for categorizing questionable payments and denials into relevant work queues, and leverage dashboards alongside key performance indicators for effective quantitative management that aids in decision-making. As the regulatory landscape evolves swiftly, it often changes course unexpectedly, which can leave healthcare providers and their patients with minimal time to adapt. Uncertainty looms over whether patients will be financially prepared or willing to settle their bills post-procedure. A critical oversight in many studies, vendor offerings, and software solutions is the subjective nature of denial definitions, which can vary significantly among physicians, billers, and healthcare institutions. To address these challenges, we offer you and your team a tailored, four-week implementation phase aimed at customizing the solution to meet your unique needs. Following the completion of this initial phase, we invite you to reach out with any queries or issues that may arise, ensuring continued support and optimization of your experience. This ongoing relationship reinforces our commitment to your satisfaction and enables you to navigate the complexities of billing and denials with confidence.
API Access
Has API
No
API Access
Has API
No
Integrations
Axys
No
Pricing Details
$1039.00/one-time/user
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
Yes
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
Yes
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
No
In Person
Yes
Vendor Details
Company Name
Vālenz
Founded
2004
Country
United States
Website
www.valenzhealth.com/valenz-assurance/abn-assistant/
Vendor Details
Company Name
Etactics
Country
United States
Website
etactics.com/appealsplus
Product Features
Medical Billing
Claims Processing
No
Claims Scrubbing
No
Code & Charge Entry
No
Compliance Tracking
Yes
Customizable Dashboard
Yes
Dunning Management
Yes
Invoice History
Yes
Patient Eligibility Checks
No
Practice Management
No
Quotes/Estimates
Yes
Remittance Advice
Yes
Product Features
Medical Billing
Claims Processing
Yes
Claims Scrubbing
No
Code & Charge Entry
No
Compliance Tracking
Yes
Customizable Dashboard
Yes
Dunning Management
Yes
Invoice History
Yes
Patient Eligibility Checks
Yes
Practice Management
No
Quotes/Estimates
Yes
Remittance Advice
No